Behavior outside social and educational norm

17. srpna 2014 v 14:43 | Prof.PhDr.Rudolf Kohoutek,CSc.
Behavior outside the social and educational norm
The following symptoms of behavior outside the norm may occur:
aggression, destructive tendencies, torturing animals and insects, bullying peers (0 - 1 - 2 - 3)
outbursts of rage (0 - 1 - 2 - 3)
maliciousness (0 - 1 - 2 - 3)
stealing, cheating, lying (0 - 1 - 2 - 3)
impertinence, vulgar language, rudeness (0 - 1 - 2 - 3)
negative attitude towards authority, arguments and disputes with adults (0 - 1
- 2 - 3)
truancy, vagrancy, spending nights away from home, little or no remorse for misdeeds (0 - 1 - 2 - 3)
Membership in problem groups, choice of unsuitable friends (0 - 1 - 2 - 3)
inciting resistance against teachers, wardens, overseers (0 - 1 - 2 - 3)
poor self-control (0 - 1 - 2 - 3)
undesirable values, consumption of alcoholic beverages (0 - 1 - 2 - 3)
obscene talk, premature sexual experience (0 - 1 - 2 - 3)
experiments with unsuitable tattoos (0 - 1 - 2 - 3)
tendency to nicotine dependency (0 - 1 - 2 - 3)
drug use experiments (0 - 1 - 2 - 3)

Dissocial personality disorder (F 60.2) has to be distinguished from behavior outsidethe social and educational norm. The former is manifested for instance by a permanent edginess and behavioral disorder during childhood and adolescence, disregard for other people's feelings, utter and permanent irresponsibility and lack of respect for social standards, rules and obligations, low tolerance for frustration and low aggression threshold, a marked tendency to blame others (marked extrapunitivity) and a severe behavioral disorder (F 91) within the meaning of the International Classification of Diseases (10threvised edition) which includes very serious symptoms - a problem individual may, for instance, use a gun which can cause grievous bodily harm to other people (e.g., a bat, brick, broken bottle, knife, firearm); manifests physical cruelty towards other people (e.g., ties, cuts or burns the victims), deliberately starts fires with the risk of causing serious damage or intending to cause same, commits a crime involving confrontation with the victim (including the grabbing of a handbag, extortion, mugging and strangling), imposes sex on another person, breaks into a house, building or car of another person.
Depending on the severity of the threat to society, behavioral disorders are classified as follows:
Dissocial behavior: Usually occurs in a certain stage of development (e.g.,adolescence) but may also be caused by a minimal brain dysfunction or neuroses. It is constituted by difficult, inappropriate, unsocial behavior which may be managed by means of adequate educational procedures under certain circumstances. It may be influenced positively. Examples: disobedience, various misdeeds, talking back, etc.
Asocial behavior: Is manifested by more serious problems which are in conflictwith social norms. The child violates moral norms, social norms, but does not break the law. An asocial person lacks adequate social feelings and empathy. Examples: truancy, running away from home, addictive behavior.
Antisocial behavior: It is basically constituted by criminal activity. The individualviolates the law and usually causes damage to himself/herself and the people around him/her in the process. Examples: theft, organized crime, sexual crimes, etc.
If education fails for any reason and the behavioral difficulty or disorder becomes very severe, the child is placed into institutional or protective educational institutions where the state acts as a surrogate family through institutional education.
This occurs for instance in those cases where:
- the parents are unable to secure conditions required for their child's healthy development in the family;
- the behavioral disorder is of such degree and severity that it jeopardizes the child's healthy development; where due to the behavioral disorder, the child
violates the law and its conduct would constitute a criminal act were the child criminally liable;
- where the child violates the law as a result of the behavioral disorder, is criminally liable and institutional (protective) education is ordered (imposed) as alternative punishment;
- where the child violates the law as a result of the behavioral disorder at the age of 12-15 in a way that would earn exceptional punishment to an adult. (Pipeková, 2006, p. 366)
This includes: children's homes (for children without behavioral disorders), children's educational institutions, educational institutions for youth, children's reform institutions and youth reform institutions. The decision on the child's placement depends on the severity of the difficulty or disorder, age, sex and type of school attended.
Voluntary reform institutions have been established recently. Children and juveniles are sent there at the request of their parents, rather than a court order. This relates for instance to Educational Care Centers (SVP) or institutions for juvenile mothers ordered to stay in institutional care. (Helena Pelcová, 2008).

Increased intropunitivity
A person with increased intropunitivity for instance:
suffers from fear or shyness in front of strangers (0 - 1 - 2 - 3)
is mentally highly vulnerable (0 - 1 - 2 - 3)
tends to take even a mild reprimand very badly (0 - 1 - 2 - 3)
overreacts to any failure (0 - 1 - 2 - 3)
tends to succumb to the rule of excessive motivation (0 - 1 - 2 - 3)
tends to speak in a low voice during examinations (0 - 1 - 2 - 3)
is unable to use his/her knowledge, has low self-confidence (0 - 1 - 2 - 3)
finds adaptation to new situations difficult (0 - 1 - 2 - 3)
tends to refuse verbal communication (0 - 1 - 2 - 3)
needs to be reassured that his/her approach is correct, requires systematic educational guidance to boost his/her self-confidence and adaptable communication (0 - 1 - 2 - 3)
tends to act in an insecure and "suspicious" manner when any misdeeds are being investigated despite his/her innocence (0 - 1 - 2 - 3)
tends to be a loner (0 - 1 - 2 - 3)
self-depreciation (0 - 1 - 2 - 3)
inability to form close relations (0 - 1 - 2 - 3)
withdrawn, frequently manifests quiet resistance, is passive aggressive (0 - 1 - 2
- 3)
tends to be shy, overly submissive (0 - 1 - 2 - 3)
overestimates other people (0 - 1 - 2 - 3).
Intropunitive children are sometimes referred to as children with communication problems (Vágnerová, 1997). The term "child with a communication problem" isdeemed to be superior to the term intropunitive personality orientation.
Further communication problems may be caused for instance by health handicaps and sensory disorders (in particular hearing, sight, touch, react, receptive or expressive element of speech, etc.).
A passive type of social adaptation, intropunitive personality orientation is closely related to the self-esteem of children, juveniles and adults.
Intropunitivity is fairly easy to diagnose by observation and interview alone, or further by means of a questionnaire and projection techniques.
Intropunitive difficility needs to be distinguished from personality disorders (formerly referred to as psychopathy).
Personality disorders are constituted by permanent character deviations whichcreate a disharmonious, unbalanced and abnormal personality in which certain elements of the personality and psyche are excessively prominent or suppressed and minimized due to maladaptation. Such disorders include the following: paranoid, schizoid, dissocial, emotionally unstable, histrionic, anankastic, anxiety, avoidant, addictive, etc.
Re-education and psychotherapy
It is advisable to supplement the re-education of intropunitivity with tailored psychotherapy.
Rational psychotherapy offers adequate, logical explanation comprehensible tothe client, advice (persuasion), explication and clarification of the substance and causes of problems and recommendation of measures and procedures in the area of mental hygiene. It may be supplemented with long-term regulatory or psychagogic guidance towards healthy life and work style and an adequate value system. It is close to education and mental hygiene.
Suggestive psychotherapy and hypnotherapy offers one-off or systematictherapeutic suggestions which may either be applied directly in hypnosis or, in a situation of mere wide-awake rapport in less hypnable individuals. It does not primarily appeal to the logical thinking and actions of the client, but rather on the client's emotivity and suggestibility. Some clients respond better to authoritative, "fatherly" suggestions of the therapist, some to more permissive, convincingly applied "motherly" suggestion accompanied by social support.
Abreactive psychotherapy, or rather abyssal abreactive psychotherapy (AAP), orrather regression therapy, employs associative memories of mental and psychosomatic problems experienced by the person in the past in stressful and traumatizing situations when the person was in a state of narrowed consciousness or even unconsciousness to induce abreaction. In some cases, various psychopharmaceuticals inducing a state between wakefulness and sleep are used.
Training psychotherapy consists of cognitive behavioral and descent exercisetechniques and programs. It involves for instance systematic desensitizing exercises in gradually aggravating adverse conditions.
Principles designed to strengthen introspection, self-confidence and effort of will focusing on self-correction (the ability to correct one's own mistakes and insufficiencies) are applied in order to improve mental health. The clients learn to face obstacles, not to bow down in front of them and not to succumb to them. They exercise to improve their muscle tone, learn to walk upright, proudly. Autogenous training is also employed.Imagination psychotherapy techniques. Unhealthy attitudes and reactions aregradually reduced and clients guided towards adult, responsible and mature actions. The Katathym imaginative psychotherapy (KIP) developed by Hans Carl Leuner (1997) can also be used. It is a technique of controlled daydreaming based on abyssal and psycho-dynamically oriented therapy the theoretical bases of which are derived from Jung's analytical psychology and psychoanalysis. It is based on the presumption that the content of day dreams reflects, on a symbolic level, preconsciousness, unconsciousness and inner conflict (Svoboda, 2003)
A combined eclectic and integrating psychotherapy is prescribed at the discretionof the psychotherapist involved (Kratochvíl, 2006). For instance, rational psychotherapy is combined with relaxation techniques (using various discs as well), individual psychotherapy is combined with group therapy. Art therapy is also employed.
Eclectic-synthetic and integrating concept of psychotherapists treating difficulties is also possible.

Partial defects in communication abilities and skills (in particular in spoken and written speech) and cognitive processes
The symptoms of this difficulty, or disorder, as the case may be, include the following:
impaired sound of speech, for instance, mumbling (0 - 1 - 2 - 3)
impaired fluency of speech and diction, for instance, cluttering (0 - 1 - 2 - 3)
impaired articulation, for instance, lisping (0 - 1 - 2 - 3)
speech defects accompanying other dominant handicaps (0 - 1 - 2 - 3)
voice defects (0 - 1 - 2 - 3)
reading and language learning difficulties, although the pupil may be doing well in mathematics, for instance (0 - 1 - 2 - 3)
confusing words and letters - at the end of first grade or later, the pupil confuses letters similar in shape or sound, e.g., r-z, k-h, d-t, n-m, a-e, p-g, d-b (0 - 1 - 2
- 3)
syllabification, unable to follow the content while reading (even in higher grades)(0 - 1 - 2 - 3)
putting even simple words together with difficulty (0 - 1 - 2 - 3)
difficulty in pronouncing more difficult groups of consonants and unknown words when reading (0 - 1 - 2 - 3)
swapping or leaving out sounds and syllables, especially end ones, when reading (0 - 1 - 2 - 3)
swapping or leaving out sounds and syllables when writing (0 - 1 - 2 - 3)
writing with grammatical mistakes (0 - 1 - 2 - 3)
inventing endings and syllables (often with mistakes) (0 - 1 - 2 - 3)
confusing letters similar in shape or sound: s-z, p-q, m-n, h-k, z-c, b-d, t-j (0 - 1 - 2 - 3)
The ability to distinguish between mirror letters is related to the development of conscious recognition of the right and left sides. In some cases, reading is merely markedly slow, cumbersome, but without typical mistakes. In writing, the child often
leaves out and adds letters, does not distinguish between hard and soft syllables: di-dy etc., letters are misshapen, the child confuses them, writes the letters in a word in a wrong order (dysorthography is associated with dyslexia in about 60% of cases).
Motor difficulties and disorders in connection with dyslexia were studied as early as the 1960s. In 1960, Z. Žlab compiled a set of tests designed to diagnose laterality and minimal brain dysfunction (MBD) which is still used today in some facilities. It consists of seven tests focusing on perception and motorics: throwing and catching a tennis ball, coordination of lower and upper limbs when marching on the spot (by wall bars), visual-motoric test with a colored circle, left-right orientation test, Z. Matějček's tracing test, rhythm reproduction test and speech examination with a focus on specific disorders. Motorics is stressed even in the classic work by Otakar Kučera et al. (1962) devoted to slight encephalopathies in children. Z. Třesohlavá (1974) in her extensive research focused on children with MBD pays great attention to the development of motorics and diagnostics of motor development. The combined occurrence of dyspraxia and dysgnosia (a developmental disorder of the ability to recognize objects) was described by Ivan Lesný (1989) who referred to it as the dy-dy syndrome, i.e., the dysgnosia - dyspraxia syndrome. Lesný classifies it as minimal brain damage and believes it is mostly caused by a disorder located in the mesencephalon. Much scholarly information on perception and motorics in MBD sufferers is contained in the publication by M. Černá et al. (1999).
The recognition of the relationship between dyslexia and motor disorders was already obvious in the preceding decades. The battery of tests used in the 1980s by H. Tymichová, the principal of the first school for dyslectics in Karlsbad, included J. Míka's orientation test of dynamic practice. In his book, Dyslexia (1987), Z. Matějček refers to the connection between poor articulation, poor fine motorics and poor coordination of fine motorics in writing.
Diagnostika specifických poruch učení (Diagnostics of Specific Learning Difficulties) by J. Novák (2002) includes a fine motorics test which is based on Lurij'sneuropsychological examination. Long-term verification showed that the current examination according to J. Míka and I. Lesný contains items which lack sufficient diagnostic merit for the respective purposes. In another treatise, J. Novák differentiates between motor dysgraphia and orthographic dysgraphia (more often referred to as dysorthography). Together with J. Smutná, they discovered a dependency between the fine motorics level and auditory analysis and synthesis (1996).
The brief overview provided above shows that the Czech approach to specific learning difficulties and minimal brain dysfunctions always included motorics and motor coordination. As the diagnosis becomes more accurate, re-education improves, and so does the understanding of the child's problems (Zelinková, 2003).
A more severe specific reading disorder (F81.0) which is included in specific developmental disorders of school skills in the International Classification of Diseases must be manifested by the following two symptoms:
1) the accuracy or comprehension score deviates by at least two standard degrees from the level expected with a view to the chronological age and general intelligence of the child, where both the reading skill and the IQ is assessed by means of an individually administered test standardized for the culture and educational system concerned.
2)anamnesis of more severe reading difficulties or test scores meeting the above criterion at an earlier age, and written test score which deviates by at least two standard degrees from the level expected with a view to the chronological age and IQ of the child.
The specific reading disorder is not caused directly by defects in visual or
auditory acuity or neurological disorder.
Other partial defects of cognitive functions include for instance reduced performance in the area of certain mental functions; disorders in speech development; counting on fingers; difficulty in abandoning an opinion and difficulty in conceiving numerical notions - dyscalculia, great difficulty in drawing and painting - dyspinxia etc.
Children with compromised communication abilities and skills are usually integrated in mainstream primary schools. However, most primary school teachers only have theoretical or no experience with compromised communication abilities. The integration of children with compromised communication abilities in primary schools would therefore benefit from the presence of a special pedagogist - speech therapist.
According to Kateřina Walková (2007), adequate development of communication abilities and skills also requires:
- correct speech model from the child's early age;
- inspiring and stimulating speech environment;
- logopedic depistage - purposeful identification of individuals with suspected impaired communication abilities;
- effective collaboration between the family, speech therapist and school;
- systematic, regular and long-term speech therapy in case of more severe difficulties and disorders;
- further education of kindergarten and primary school teachers in speech therapy issues.
 

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