Oppositional D efiant Disorder; Changing Mindsets to Help Students Succeed

1. Oppositional Defiant Disorder; Changing Mindsets to Help Students Succeed Joe Zima, LMSW Behavior Specialist St Clair County RESA

2. Objectives • Gain an understanding of diagnostic criteria for ODD and CD. • Understand the importance of using a 4 step systematic process to ensure school success for defiant students. • Leave this session with usable strategies for defiant students.

3. Acknowledgements • Jason Novetsky • Steve Vitto • Michael Bloomquist and Steven Schnell, Helping Children with Aggression and Conduct Problems

4. Are You Stuck??? • Stuck.wmv

5. Are You Stuck??? “I expect for **** to fail out of school, end up on welfare, and spend most of his time watching TV from his grandmothers couch. So I will try some strategies but I don’t have any hope that they will work.”

6. Why Your Expectations Matter • Counselors, Doctors, or Teachers hold beliefs about a persons ability to change. • In a research study, conducted in three different alcohol treatment programs, patients identified to staff as having a high potential for recovery (but who had been chosen at random) were significantly more likely to be sober and working a year after discharge.

7. Why Your Expectations Matter • Perceived prognosis influences real outcomes. • movie clips\Learning_Behavior-expectation experiment harvard.wmv

8. Why Your Expectations Matter • Perceived prognosis influences real outcomes. • movie clips\Bad-assTexasrabbit.wmv

9. All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family, and academic life.

10. What is Oppositional Defiant Disorder? ODD is a persistent pattern (lasting for at least six months) of negativistic, hostile, disobedient, and defiant behavior in a child or teen without serious violation of the basic rights of others.

11. What are the Symptoms of Oppositional Defiant Disorder? A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present: • Frequent loss of temper • Arguing with adults • Defying adults • Refusing adult requests or rules • Deliberately annoying others • Blaming others for mistakes and misbehavior

12. Oppositional Defiant Disorder • Being touchy or easily annoyed • Being angry and resentful • Being spiteful or vindictive

13. What Causes Oppositional Defiant Disorder? • The cause of Oppositional Defiant Disorder is unknown at this time. The following are some of the theories being investigated: • It may be related to the child's temperament and the family's response to that temperament. • A predisposition to ODD is inherited in some families. • There may be problems in the brain that cause ODD. • It may be caused by a chemical imbalance in the brain. Children with ODD have often experienced a break in attachment or bonding during the first 2 years of life Ross Greene, Russell Barkley, Mel Levine

14. DSM IV Conduct Disorder Criteria • For 12 months or more has repeatedly violated rules, age-appropriate societal norms or the rights of others. • Shown by 3 or more of the following, with at least one of the following occurring in the past 6 months: • Aggression against people or animals • Frequent bullying or threatening • Often starts fights • Used a weapon that could cause serious injury • Physical cruelty to people • Physical cruelty to animals • Theft with confrontation • Forced sex upon someone

15. 4 step systematic process • 1) Data support & functional assessment • 2) BIP • 3) Data tracking and review • 4) Objective modification “The four steps used to address defiant behaviors are…” All building staff should be able to complete this sentence.

16. Procedures Help • To stay calm • To remain objective • To make rational decisions • To stay away from intervention, after intervention, after intervention…

17. Scatter Plot, Scatter Plot, Scatter Plot… • 1) Data support & functional assessment • Behavior specialist referral\Weekly_Scatterplot.pdf • defiance\Frequency Chart.doc http://www.resa.net/curriculum/positivebehavior/tierthree/

18. Using Your Scatter Plot • Target Behavior, 1’s track sarcastic student responses • Target Behavior, 2’s track threats made by principal • 11:30 am • movie clips\THE_BREAKFAST_CLUB.wmv

19. It is important to distinguish between a won’t problem and a can’t problem • Can be difficult to assess • Treating a can’t problem with punishment can cause distrust and alienation • Treating a won’t problem with punishment and reward programs can result in deceit and manipulation

20. It is important to distinguish between a won’t problem and a can’t problem • Functional Assessments\st clair county FBA(simple).doc

21. OTHER DISORDERS THAT MAY MANIFEST IN DEFIANCE • ODD/CD • ADHD • Childhood Bipolar Disorder • Emotional Impairment • Down’s Syndrome • Fragile X • Prader-Willi Syndrome • TBI • ASD/Aspergers Syndrome

22. Bloomquist and Schnell • Aggressive/Conduct Problem (ACP) • Children who manifest some form of early-onset aggressive behavior and who also display, or who are at risk for displaying covert antisocial actions.

23. Contra-Indicated Behavioral Strategies for the ODD Child • Ultimatums • Strict Boundaries: Drawing the Line in the Sand • Counts, Warnings, Threats • Prolonged Eye-Contact • Infringing on Personal Space • Social Disapproval • Judgmental Responses • Response Cost and Punishment • Strict Boundaries or Contracts • Suspension and Detention, Progressive Discipline Marion

24. Boston 24/7 • Any contra-indicated strategies? • movie clips\ABC News Boston clip 1.wmv • movie clips\ABC News Boston clip 2.wmv

25. Basic Principles Challenging behavior can often be eliminated or substantially reduced by a change in adult behavior.

26. Evidence Based Classroom Environment ARE WE USING THEM IN OUR CLASSROOM? • Environmental Supports • Relationship Based? • Positives Outweigh the Negatives? • Teaching Social Skills? • Clear Expectations taught and reviewed? • Procedures for transitions? • Positive Home School Partnerships • Consistent Brief Consequences that promote the development of replacement behaviors?

27. Behavior that promotes power struggles • Threatening student • Responding emotionally • Confronting publicly • Responding quickly • Offering bribes • Trying to convince • Put downs

28. Behavior that decreases the chance of power struggles • Providing directives + choices • Set pre-determined consequences • Listen before reacting • Use calm voice + manner • Maintain privacy • Walk away before getting too hot

29. BIP • 2) Use the last couple slides to double check your BIP. Only change the BIP based on scatter plot data. • If you have strategies that support treatment of ODD and strategies that are not supportive of treating ODD, you now have a BIP checklist.

30. FAST Program • Lets watch an example! • http://www.lookiris.com/store/K-12_Professional_Development/The_FAST_Method/

31. Sun Tzu- The Art of War “The best battle is the battle that is won with out being fought” -Sun Tzu The Art of War

32. According to Research, the LEAST EFFECTIVE responses to problem behavior are: • Counseling • Psychotherapy • Punishment (Gottfredson,1997; Lipsey, 1991; Lipsey & Wilson, 1993; Tolan & Guerra, 1994) • Exclusion is the most common response for conduct-disordered, juvenile delinquent, and behaviorally disordered youth (Lane & Murakami, 1987) but it is largely ineffective.

33. Why do we often use strategies that research indicates to be counterproductive with defiant students? • When WE experience aversive situations, we select interventions that produce immediate (rather than sustained) relief. We tend to focus on our concerns, not the student’s.

34. According to Research, the MOST EFFECTIVE responses to problem behavior are: • Social skills training • Academic and curricular restructuring • Behavioral interventions(Gottfredson, 1997; Lipsey, 1991, 1992; Lipsey & Wilson, 1993; Tolan & Guerra, 1994)

35. Helping Children with Aggression and Conduct Problems

36. Bloomquist and Schnell • “Self management techniques have produced positive effects on academic behaviors for children with behavior problems” • (Carr & Punzo, 1993; Levendowski & Cartledge, 2000; McQuillan, Dupaul, Shapiro, & Cole, 1996)

37. Bloomquist and Schnell • “A review of 16 studies using self-management techniques with children who were behaviorally disordered found ‘moderate to large effects’ on social and academic behaviors” (Nelson et al., 1991) • Academic behaviors included on-task behavior and accuracy of work.

38. Bloomquist and Schnell • Limitations of self-management “long term effects (Carter, 1993) and insufficiency of self-monitoring and self-evaluation as stand-alone interventions” (Evans & Sullivan, 1993)

39. Bloomquist and Schnell • Conclusion • “As a result, self-management would seem to be a strategy that should be used as one component of a more comprehensive intervention for children with ACP”

40. Self-management program example • Practical Ideas That Really Work for Students with Disruptive, Defiant, or Difficult Behaviors McConnell, Ryser, Patton

41. How did I do? • Six steps in beginning self-management • Describe a specific behavior, use an action verb to describe: Read your book silently, Raise your hand for help, Work on math for 20 minutes • Teach students to check on their own behavior, model self-talk: Am I reading silently, Did I raise my hand for help, Did I work on Math for 20 minutes.

42. How did I do? • Give students an opportunity to practice asking themselves the question silently. • Proceed with the lesson or activity. • When students have completed the assignment, suggest that they ask themselves, “how did I do?” on the specific behavior. After the question is asked silently, they can fill out the rating form.

43. How did I do? • Use the rating forms as the basis for discussion and feedback with the entire class or individual students. Help students improve their self-evaluation and teach them to set goals for improvement.

44. Strategies for ODD Practical Strategies for Students with Disruptive, Defiant, or Difficult Behaviors. -McConnell, Ryser, Patton

45. Assessment/Evaluation Form *Use PDF File To Display Here*

46. Data Tracking Interventions and Objective Modifications • 3) Systematically track the impact of evidence based interventions. • 4) Make modifications based on your data.

47. Thank You! Please contact me with any questions or requests for materials: Joe Zima, LMSW 810-455-4045 zima.joe@sccresa.org