School Psychology

Classifying Conduct Problems

May 13, 2018

Every child can experience behavior difficulties. Sometimes children defy our requests, act out, say unkind things, or threaten to harm others. When you think back to your childhood you can probably find a few examples of yourself displaying these behaviors. I can remember lying to my parents about why I didn’t finish my homework or glancing off of someone else’s paper while taking a test. Maybe you remember sneaking out late at night to hang out with friends or “accidentally” tripping someone in the hallway? The point is everyone makes bad decisions, but for some children and adults this behavior is a pervasive way of life for them. For the purposes of this post we are going to explore Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD).

What is ODD?

This condition can be diagnosed as soon as early elementary school. These children have a long pattern on behavioral difficulties, including: anger, irritability, losing their temper, easily annoyed, arguing with adults, breaking the rules, purposefully annoying others, blaming others, and seeking revenge. You may be thinking I’ve done all of these things or most of my students have exhibited these behaviors, but children with ODD displays these symptoms for at least 6 months at a severe level.

Are parents to blame?

Sometimes parents are often blamed for not disciplining or teaching their children better. However, when a child exhibits these extreme behaviors it has an extremely negative impact on family dynamics which strengthens these negative behavior patterns. In other words, typical parenting strategies don’t always work on children with these characteristics. Their parents often love them and are struggling to find strategies that work.

Then, what can cause ODD?

Around 30-50% of children with ADHD may also have ODD. If a child already struggles with sustaining attention, is easily distracted, impulsive, and hyperactive it will likely get them into situations where they are “pushing the limits.” This causes them to receive more negative feedback than positive feedback from adults. This creates a pattern of interactions that can lead to a child developing ODD.

Sometimes there are signs early on, such as a baby being difficult to sooth or a toddle having frequent temper tantrums. These early difficulties with managing emotions can be a risk factor for developing ODD. Other risk factors for developing ODD are experiencing trauma and significant stress.

What can be done?

The main focus on treatment programs is often not the child but the parent. Parents need support to help heal the parent-child connection. Often parents are either being too strict or too permissive in a response to these severe behaviors their children are displaying. A therapist can help parents set clear boundaries with their children and learn how to consistently follow through.

At school, a social skills training program could help the student learn pro-social ways of engaging with others and managing conflict. Counseling may also help the children deal with anxiety, depression, and learn coping skills.

What about medicine?

While the FDA has not approved any medication specifically for ODD, often children may take anti-psychotic medications, antidepressants, or medications to help manage their symptoms of ADHD. Even if a child is taking medicine it will be important for a behavioral intervention plan to also be in place.

What can teachers do?

  1. Remember you are not alone! Consult with your school counselors, behavior interventionists, school psychologist, etc. for help.
  2. Allow the student breaks to “cool down”
  3. Avoid “why” questions as it can imply blame. For example, instead of “Why did you get in a fight?” say “What do you think made you angry?”
  4. Use reflective writing worksheets after misbehavior
  5. Avoid arguments/power struggle. Do not raise your voice.
  6. Give choices whenever possible
  7. Give special jobs or responsibilities to this student.
  8. Use positive phrasing instead of negative. For example, instead of “Go sit down now” say “I will come help you once you are seated.”
  9. Give behavior specific praise immediately after a positive behavior occurs. Identify the behavior and state why you liked it.
  10. Make an effort to praise them more often than the average student even for small positive behaviors.
  11. Keep your tone calm, be brief, and professional. Try to stay neutral. Give limited attention when behaviors are negative. For these students negative attention can be rewarding.
  12. Take time to actively listen and build a relationship with these students. Even meeting with them once a day for 2 minutes to talk about preferred interests can make a difference.
  13. Intervene as early as possible to help deescalate the student’s anger.
  14. Watch your body language when approaching them. Make sure not to have your hands on hips or pointing fingers. Give yourself 10 seconds to take a deep breath before responding.
  15. Use Two-Part Choice Statements. For example, “You can choose to finish your work now and earn a break or you can choose to not finish your work and walk laps at recess.”
  16. Validate their emotions. For example, “You seem mad. Can you please tell me what is going on?”

What is Conduct Disorder?

A few children with ODD will develop Conduct Disorder in the future. This is a more severe diagnosis. These students are often engaging in criminal activity, including, stealing, hurting animals, harming people, destroying property, or setting fires. Intervening early for ODD can decrease risk factors for CD.

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