Overview of Disruptive Behavior Problems

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Overview of Disruptive Behavior Problems

• Students with disruptive behavior disorders are a
  heterogeneous group
• Most are boys
• However, conduct problems are not uncommon among
  adolescent girls

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Overview of Disruptive Behavior Problems

• Many youngsters exhibit individual traits and
  behaviors in early childhood that foreshadow a
  developmental path leading to more destructive
  and aggressive behaviors as adolescents and
  adults

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Overview of Disruptive Behavior Problems

• One of the difficulties in identifying these
  disorders is that a certain amount of rowdy play
• Risk factors may contribute to the development of
  these disorders

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Overview of Disruptive Behavior Problems

• Collectively, these risk factors are producing
  children and youth who
• A-see violence as a viable means of solving
  problems
• B-dont respect the rights of others
• C-are not socially responsible
• d-have not been taught basic manners and social
  conventions

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Overview of Disruptive Behavior Problems

• E-dont value human life as they should
• RISK FACTORS AND PREDICTORS OF DISRUPTIVE
  BEHAVIOR DISORDERS
• Individual factors that predispose a child to
  disruptive behaviors include

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Overview of Disruptive Behavior Problems

• 1- a difficult temperament
• 2-cognitive or learning impairments
• 3-neuropsychological problems
• 4-mental illness

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Overview of Disruptive Behavior Problems

• Family predictors of disruptive behavior include
• 1-harsh and ineffective parenting
• 2-parental antisocial and pathological components
• 3-parents with alcohol and drug dependencies
• 4-interrupted parenting

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Overview of Disruptive Behavior Problems

• History of abuse or neglect
• Later adoption age
• Prenatal drug exposure
• Multiple foster placements prior to adoption

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Overview of Disruptive Behavior Problems

• School Factors that may contribute to behavior
  disorders
• 1-academic factors
• 2-negative relationships with peers and adults
• 3-punitive school environment

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Overview of Disruptive Behavior Problems

• Community factors include
• 1-access to drugs and alcohol
• 2-exposure to violence
• 3-lack of educational and employment opportunity
• 4-acceptance of aggression as a problem solving
  strategy

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Overview of Disruptive Behavior Problems

• Treatment Options
• 1-Results of treatment interventions in
  residential settings have not transferred to
  natural setting including the home or school
• 2-School based group intervention studies have
  been few in number and the results have shown
  students with disruptive behavior patterns to be
  very resistant to treatment

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Types of Disruptive Behavior Problems

• DSM-IV-TR (Diagnostic and Statistical Manual of
  the American Psychiatric Association) lists four
  clinical diagnoses that may be appropriate for
  students with specific patterns of disruptive
  behaviors. These include

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Types of Disruptive Behavior Problems

• A-Oppositional defiant disorder (ODD)
• B-Conduct disorder (CD)
• C-Disruptive behavior disorder-not otherwise
  specified (DBD-NOS)
• D-Intermittent explosive disorder (IED)

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Oppositional Defiant Disorder (ODD)

• DSM describes oppositional defiant disorder as a
  recurrent pattern of negativistic, defiant,
  disobedient, and hostile behavior toward
  authority figures that persist for at least 6
  months.

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Oppositional Defiant Disorder (ODD)

• Behaviors of ODD include
• 1-losing temper
• 2-arguing with adults
• 3-defiance/noncompliance with adult requests
• 4-deliberately annoying others, blaming others or
  being easily annoyed
• 5-angry/resenstful attitude
• 6-spiteful/vindicyive attitude

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Oppositional Defiant Disorder (ODD)

• Actively defy rules
• Deny responsibility for their behavior
• Exploit others for their own gain
• Students with ODD seem to thrive on conflict,
  anger, and negativity from others and are often
  most difficult with the people they know well

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Oppositional Defiant Disorder (ODD)

• Prevalence between 1 and 6 of the
  population-Surgeon Generals Report
• DSM reports it as between 2 and 16
• More common in males who were tempermental or
  hperactive preschoolers
• ODD prevalence after puberty is equal between
  boys and girls
• Generally observed before the age of 8 but may
  emerge through late adolescence

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Oppositional Defiant Disorder (ODD)

• Co morbid condition a condition or disorder
  occurring concurrently with another disorder
• ODD often occurs with ADHD which complicates the
  diagnosis

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Oppositional Defiant Disorder (ODD)

• Experts have described ODD as a developmental
  antecedent to Conduct Disorder (CD) for a
  significant number of children.
• If this occurs the diagnosis should be CD rather
  than ODD

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Conduct Disorder (CD)

• DSM describes CD as a repetitive and persistent
  pattern of behavior in which the basic rights of
  others or age-appropriate societal norms or rules
  are violated

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Conduct Disorder (CD)

• They describe these behaviors as fitting into
  four groups
• 1-Aggression toward people and animals\2-Harm to
  property
• 3-Deceitfulness or theft
• 4-Serious rule violations

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Conduct Disorder (CD)

• Associated features and mental disorders that may
  occur with CD, as follows
• 1-little empathy or concern for the rights and
  feelings of others
• 2-Frequent misperceptions of others intentions
  as hostile or threatening and responding with
  aggression

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Conduct Disorder (CD)

• 3-Callous, lack of feelings of guilt or remorse
• 4-Low or overly inflated self esteem
• 5-Early onset of risk-taking behavior including
  sex, drinking, smoking, using drugs

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Conduct Disorder (CD)

• 6-High rates of suicidal ideation
• 7-Lower than average cognitive ability,
  especially verbal IQ

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Conduct Disorder (CD)

• The long term prognosis for students with CD is
  grim
• Prevalence between 1 and 4
• More than ¼ to ½ of all individuals with CD go on
  to become antisocial adults
• DSM indicates between 1-10 of the population
• Higher than males than females

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Conduct Disorder (CD)

• CD may be evident as early as preschool, but most
  significant symptoms emerge from middle childhood
  through middle adolescence
• Childhood-onset CD is most common in males and is
  frequently preceded by a diagnosis of ODD. Early
  diagnosis has a poor prognosis
• Co morbid conditions with CD

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Disruptive aBehavior Disorders-Not Otherwise
Specified (NOS)

• DBD-NOS is used by DSM to classify children whose
  behavior is oppositional/defiant or conduct
  disordered, but does not meet all the required
  criteria for either ODD or CD.

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Intermittent Explosive Disorder (IED)

• While the DSM-IV TR does not classify
  intermittent explosive disorder (IED) as a
  disorder often diagnosed in childhood or
  adolescence, it is a diagnosis some students
  bring with them to school. It is characterized by
  infrequent, unexpected outbursts of disruptive
  behavior that result in significant harm to
  people and/or property.

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General Rules for Classroom Management

• The most important element in classroom
  management is to have a plan. Answer the
  following questions to see if you are 'ready for
  anything'.
• 1. What do students do when they come into your
  classroom in the morning? After recess and
  lunch?2. What is the consequence for not
  completing assigned work both in class and
  out?3. What is the consequence for student(s)
  interrupting the class or a small group?

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General Rules for Classroom Management

• 4. How do your students request to leave the room
  for a drink or to visit the washroom?5. What is
  the process for the whole class leaving for lunch
  or recess or to go to the gym?6. What is the
  consequence for the child who forgets things?

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General Rules for Classroom Management

• 7. After giving a set of instructions or
  directions, what is in place for the student(s)
  that still don't understand?8. How do you
  respond to the child that keeps leaving his/her
  seat?9. How will your students know about
  acceptable voices/noise levels to use for the
  various activities?

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General Rules for Classroom Management

• Basic psychology of children with behavior
  disorders-What the teacher needs to know.
• Level I Behavior Disorders
• Level II Behavior Disorders

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Management of Conduct Disorders

• The youth at highest risk of extreme violence may
  be the conduct disordered child.
• Remember that the hallmark of being a conduct
  disorder (c.d.), is having no heart, no
  conscience, no remorse.

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Management of Conduct Disorders

• Only a mental health professional can diagnose a
  conduct disorder for sure, but being aware that
  you may have a conduct disordered child in your
  class or group, is important to ensuring your
  safety, along with the safety of your kids,
  because you work with conduct disorders
  completely differently than other kids.

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Management of Conduct Disorders

• Since the c.d. child has little relationship
  capacity, you should not use relationship-based
  approaches with a diagnosed conduct disorder.

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Management of Conduct Disorders

• It would be insensitive to call a conduct
  disorder a "baby sociopath," but that is close to
  what the term means. It means that the child acts
  in ways that appear to be seriously anti-social,
  and the concern is that the child may grow up to
  be a sociopathic type of person

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Management of Conduct Disorders

• Since this child cares only about himself (c.d.'s
  are predominately male), there are little brakes
  on this child from serious or extreme violence.

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Management of Conduct Disorders

• DO'S
• The main point we give in our classes is that
  these children operate on a cost-benefit system,
  and that to control your c.d. kids, you must keep
  the costs high, and benefits low.

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Management of Conduct Disorders

• Your goal is to teach them that when they hurt
  others, it often hurts them too. All
  interventions must be in the context of "I-Me,"
  because that is all this kid is capable of caring
  about.

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Management of Conduct Disorders

• Don't have a heart-to-heart relationship.
• Don't work on building trust.
• Don't put an emphasis on compassion, caring,
  empathy, values, morals.
• Don't expect compassionate behavior.
• Don't trust.
• Don't give second chances.
• Don't believe they care or feel remorse.

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Management of Conduct Disorders

• Conduct disorders are "wired" differently than
  other students. That means that they may not be
  able to care. Because of that difference, the
  following interventions will fail character ed,
  values clarification, empathy building, second
  chances, making amends, and more-- far too many
  to list here. These methods fail because the
  child must care about others if these techniques
  are to work.

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Management of Conduct Disorders

• These approaches are absolutely fine for other
  types of children, but will never be of value
  with C.D.s. In fact, these methods make the
  situation worse because they communicate to these
  children that you don't understand who they are,
  and don't understand how to control them. That
  perception generally leads these youngsters to
  believe that they may be able to do whatever they
  want without having to deal with consequences
  that would be of significant concern to them.

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Management of Conduct Disorders
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