Wednesday, April 28, 2010

Definition of ODD

What do you want me to say, THEY JUST DON’T DO AS THEY ARE TOLD! (S. Flood)



According to the Offord Centre for Child Studies, "Oppositional Defiant Disorder (ODD) is a type of behaviour problem in which children are openly hostile, uncooperative, and irritable. They lose their tempers and are mean and spiteful towards others. They often do things to deliberately annoy other people. Most of their defiant behaviour is directed at authority figures, but they also sometimes behave the same way towards their siblings, playmates, or classmates. Their home life, school life, and peer relationships are seriously negatively affected because of the way they think and behave".

Symptoms of Oppositional Defiant Disorder

Symptoms of ODD may include (http://www.mayoclinic.com/):

• Frequent temper tantrums

• Excessive arguing with adults

• Often questioning rules

• Active defiance and refusal to comply with adult requests and rules

• Deliberate attempts to annoy or upset people

• Blaming others for his or her mistakes or misbehavior

• Often being touchy or easily annoyed by others

• Frequent anger and resentment

• Mean and hateful talking when upset

• Spiteful attitude and revenge seeking

• Aggressiveness towards peers • Difficulty maintaining friendships

• Claims not to care about losing privileges as a consequence to negative behaviour

What Teachers Want To Know

Instructional/Classroom StrategiesWorking with an ODD Student

Focus on Prevention:

Identify activities that will cause frustration and help develop coping mechanisms.

Academic work needs to be at the appropriate level for the student.

Too easy or too difficult will lead to problems in the classroom.



Establish Expectations:

Clearly state behavioural expectations using simple, straightforward language

List two or three behavioural goals for the student

Have the student state the goals at the start of the day

Have the student restate the goals as needed

Examples may include: “Keep my body in my own personal space.” “Following directions”

Be clear about non-negotiable rules

Rule centred classroom as opposed to authority centred classroom

Teacher defers to the power of the rule rather than teachers power

This may include: “Since you broke the rule this is what you will do…”

“Be ready to go when the bell rings.”

Rules must be applied consistently

Limit setting needs to be calm, clear, firm and supportive

Do not allow the student to argueRestate the consequence when a rule is broken

Post the daily schedule



Logical Consequences:

Consequences are designed to teach not punish

Whenever possible allow the student to choose between two consequences

Students should be held accountable but develop empathy



Praise/Behavioural Reinforcement:

Be sure to reward good behaviour

A smile or word of praise can mean a great deal

Avoid expressing feelings, lecturing, threatening or raising voice

Concrete reinforcement or sanctioned power reinforces desired behaviour

Tokens, stickers or marks on a chart may be traded for reinforcing privileges

Take time to learn which reinforcements will motivate the student

After completing non-preferred activity, reinforce with preferred activity

Meet privately with student to raise specific concerns

Agree that you will be respectful to each otherBe calm discussing student’s actions

Questions may include: “Tell me what you think the problem is that keeps you from being successful in school?”

Listen without interrupting



Sustained Commitment:

Child may thwart efforts to help and support

May worsen before getting better

May take a long time



Compassionate and Understanding:

Understand the dynamics underlying the behaviour

Understand the present environment and where the difficulties begin

Understand the students’ perception

Understand the motivation behind the behaviour



High Levels of Stimulation:

Risk taking, physical activity, and high interest - integral part of the school day

Without these the student will move to unacceptable and problem venues for stimulation



Skill for Emotional Management/Affective Regulation:

Structured and supported activities with some degree of aggressive competition

Carefully supervised as student will fail before developing necessary skills

Structure assignments to allow for redo time to improve grades

Questioning may include: “Is what you are doing working for you?”

“What would work better?”

“What could you have done to avoid the problem?”

“How may I help you?”



Time-Out:

Self imposed to cool down and/or regain perspective

Not used as a punishment or threat

Used as an opportunity if signs of agitation or escalation are detected early

Questions may include: “Would time in the rest area be helpful?”

“Your time will begin when you get to the rest area.”

Allowing stimulating activities in the time-out space will yield better results

Activities such as clay to squeeze, a pillow to wring or magazines to tear



Opportunities to Practice Generosity:

Combine behavioural intervention with moral development

Give student opportunities to give to others to develop caring individuals



Support for Staff:

Student success is dependent upon adult ability

Constructively process feelings toward the student

Have a mechanism for dealing with students overwhelming emotions

Understand that you are not the cause of the defiance

Meet with other adults dealing with the student to present a united front

Have all adults agree on a behaviour plan for the child with no more that one reminder.”



Suicidal Risk/Crisis:

If student is showing any of the following, contact your school’s mental health crisis team immediately or call 911

Threats or attempts to hurt or kill oneself

Looking for the means (i.e. gun, pills, rope)

Making final arrangements (i.e. writing a will, farewell letter, or giving away prized possessions)

Pre-occupation with suicide or dying (usually expressed through another avenue) in conjunction with depression or high risk behaviour

Showing sudden improvement after a period of extreme sadness and/or withdrawal

Did You Know

- more males than females are diagnosed with Oppositional Defiant Disorder (ODD) before puberty (http://www.msu.edu/)

- after puberty the numbers are equal (http://www.msu.edu/)

- between 5% and 15% of school aged children have ODD (Offord Centre for Child Studies)

- more common in urban than in rural areas (Offord Centre for Child Studies)

- developmental progression: ADHD is usually followed by ODD and then by Conduct Disorder (Children's Mental Health May 31, 2001)

- some students may develop ODD as a result of stress and frustration from divorce, death, loss of family, or family disharmony (http://www.macmh.org/)

- ODD may be a way for the student to deal with depression or may be the result of inconsistent rules and beahviour (www.macmh.org)

Tips for Parents

Parents can help their child with ODD in the following ways:

• Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation.

• Take a time-out or break if you are about to make the conflict with your child worse, not better. This is good modeling for your child. Support your child if he decides to take a time-out to prevent overreacting.

• Pick your battles. Since the child with ODD has trouble avoiding power struggles, prioritize the things you want your child to do. If you give your child a time-out in his room for misbehavior, don’t add time for arguing. Say “your time will start when you go to your room.”

• Set up reasonable, age appropriate limits with consequences that can be enforced consistently. • Maintain interests other than your child with ODD, so that managing your child doesn’t take all your time and energy. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.

• Manage your own stress with healthy life choices such as exercise and relaxation. Use respite care and other breaks as needed