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Children with serious emotional disturbance must be treated, so they have good quality in their live. Improving outcomes for children with serious emotional disturbance depends not only on improving their school and learning opportunities, but also on promoting effective collaboration across other critical areas of support: families, social services, health, mental health, and juvenile justice. Although bringing about such collaboration poses a major challenge—due to different system priorities, agendas, structures, and ways of operating—the results of collaboration for children with serious emotional disturbance and their families include greater school retention and improved educational, emotional, and behavioral development.

Our study examines the efforts, experiences, and outcomes for three urban sites that have struggled, with some success, to overcome the challenges to creating a comprehensive, school-based system of care.

Children with serious emotional disturbance may be eligible for special education and related services under the Individuals with Disabilities Education Act (IDEA); however, although mental health researchers estimate that up to 19 percent of the student population exhibit symptoms of serious emotional disturbance, only one percent of students are identified and referred for the necessary support services.

Indeed, national evaluation data from the Center for Mental Health Services (CMHS) reinforce the point that many children and youth with serious emotional disturbance are not receiving special education services.

Specifically, students with serious emotional disturbance fail more classes; miss more days of school; have lower grades; are retained at the same grade level; drop out more frequently; have a lower graduation rate; and have a higher dropout rate than other students with disabilities.

The education system has struggled to accommodate the needs of children and youth with serious emotional disturbance and to effectively integrate them into mainstream classrooms. In 1984, Congress authorized the National Institute of Mental Health to start the Child and Adolescent Service System Program (CASSP) to help states develop comprehensive, community-based systems of care for emotionally disturbed children and youth.

However, neither IDEA nor CASSP has had a significant impact on the education of children with serious emotional disturbance, as observed by Congress during the 1990 reauthorization of IDEA. As a result, the U.S. Department of Education developed the National Agenda for Achieving Better Results for Children and Youth with Serious Emotional Disturbance. The Agenda’s targets include expanding positive learning opportunities; strengthening school and community capacity; addressing issues of diversity; collaborating with families; promoting appropriate assessment; providing ongoing skill development; and creating comprehensive and collaborative systems.

Education plays a critical role in the development of children. Positive learning experiences help to prevent emotional and behavioral problems. Furthermore, schools provide a logical setting for both early identification of children at risk for serious emotional disturbance and for effective provision of services.

Gastroesophageal reflux disease, also referred to as GERD or acid reflux disease, is an illness where the liquefied contents of the sufferers stomach backs up into their esophagus. The stomach contents that is regurgitated contains acids and pepsin that may cause quite severe damage to the esophagus although this only happens in very few cases. Acid reflux disease is a chronic disease and once you contract it you are likely to become a lifelong sufferer. If the esophagus does become damaged this is also a chronic disease. Treatment can be given to improve the state of the esophagus wall but if the treatment is stopped the problems can return within a matter of weeks.

1- Heartburn is by far the most common symptom of acid reflux disease and if a doctor suspects your heartburn is cause by acid reflux disease he or she will prescribe you with a medicine that stops the production of acid in your stomach. If it stops then it is assumed that you do indeed have acid reflux disease. This approach of diagnosis can be unreliable.

2- An endoscopy is another way of diagnosing acid reflux disease. A tube is swallowed so that doctors can see exactly what is going on inside your body. However, a esophagus of a patient suffering from the disease ordinarily looks quite normal so this method of diagnosis will only directly work for those patients whose esophagus has been damaged by their acid reflux disease. However, if an ulcer or other ailment that can cause similar problems is spotted then it may be possible to discount acid reflux disease.

3- Biopsies can be used to search for the existence of cancer. They can not be used to look for evidence of acid reflux disease but alternative causes of symptoms may be found.

4- Examining the throat and larynx is an approach that is sometimes consider for the diagnosis of acid reflux disease. Inflammation of either may indicate that a patient has acid reflux disease but there a number of other problems that may cause these symptoms too.

5- Esophageal acid testing is probably the most accurate way to test for acid reflux disease but is the most obtrusive as well. A tube is placed through the nose and into the esophagus where it remains for 24 hours. This tube has a sensor on the end and measures the amount of reflux generated over 24 hours.