Oppositional Defiant Disorder

Definition: Oppositional Defiant Disorder is a pattern of negativistic, aggressive, and defiant behavior without the more serious violations of the basic rights of others that are seen in conduct disorder. A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects a students educational performance: An inability to learn that cant be explained by intellectual, sensory, or health factors; An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; Inappropriate types of behavior or feelings under normal circumstances; A generally pervasive mood of unhappiness or depression; or A tendency to develop physical symptoms or fears associated with personal or school problems. Specific DSM IV ODD Criteria: For at least 6 months, shows defiant, hostile, negativistic behavior (4 or more of the following): * Arguing with adults * Deliberately doing things that annoy others * Losing temper * Actively defying or refusing to carry out the rules or requests of adults * Blaming others for own mistakes or misbehavior * Being angry and resentful * Being spiteful or vindictive * Being touchy or easily annoyed by others Causes: *The exact cause of ODD is not known.* Some researches believe that cause may be related to certain biological and environmental factors, such as: A childs temperament and the familys response to it A childs social skills A childs ability to communicate through language How parents discipline and understand the child The way a childs body adjusts to arousal and stimulation Having parents who are overly concerned with power and control Disruptive childcare An inherited disposition to the disorder, possibly both environmental as well as genetic Neurological damage

FEW FACTS: Studies show that five to 15% of all school-age children have ODD All children display most of these behaviors from time to time ODD does not usually exist alone: Fifty to sixty-five percent of children with ODD have ADHD 35% develop some form of affective disorder 20% have some form of mood disorder 15% develop some form of personality disorder Connection to Conduct Disorder Conduct Disorder (in DSM-IV): repetitive and persistent pattern of behavior in which either the basic rights of other or major age-appropriate societal norms or rules are violated. In the DSM-IV, a diagnosis of CD preempts a diagnosis of ODD. Focus on ODD symptoms may help prevent CD. However, some clinicians state that the relation of ODD to CD may be overstated. Diagnosis If a psychiatrist suspects ODD, he or she will first: Talk with the child and with their parents. Review the childs and the familys history. Obtain information about the childs functioning in school Look for signs of other disorders in the child. How can we handle children with Oppositional Defiant Disorder? FIRST STEP Change your mindset: These are not problem behaviors or bad behaviors. These are behaviors you would like to target for change. When you say words like bad behavior and problem behavior, a perception of the child forms in your mind. BAD KID- PROBLEM KID- Get the kid out of here. The child is okay; it is just the behavior you would like to go away- so target it. Design a Multimodal Treatment One intervention is not going to change the childs behavior. You will need: Antecedent modifications Things you do before a behavior has a chance to show up You determine when those need to be employed by looking at behavior patterns: Time of day Day of the week

Contexts, settings, subjects being presented, certain peers being around, certain adults being around etc. You will need to teach replacement behaviors: This child has learned that certain behaviors have a pay off The child will have to be taught ways to release anger and frustration in socially appropriate ways. We cannot just tell them to be good, we have to actually give them techniques that will help them do something different. You will need to make consequence modifications: Everyone hates this one because it is What will you do different when the behavior occurs? We dont like to think about changing ourselves. How will we avoid paying off with attention or escape from work consequences and yet still manage the behavior? How do we refrain from going to brain stem?

The multi-modal plan: Does not just put one statement in place: Consider if your doctor said, Get better. No different to tell a child with a medical diagnosis to Be Good. (it only works for ET) School-wide PBIS (Positive Behavioral Interventions and Supports) The focus of Sw-PBIS is on teaching appropriate behavior by the TIPP method: Teach the behavior Imprint the behavior by modeling it for the students Practicing the behavior Praising the behavior when you see it. Label appropriate behavior Instead of telling the child what NOT to do- tell them what to do by labeling it when you see it. I like the way you.(the more you say- the more youll see.) Get rid of the totalitarian rules: Dont __________ No ____________ Quit ____________ Stop ____________