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Jan 192014
 

Welcome to the BehaviorAdvisor.com blog!

Find more posts regarding behavio(u)r on facebook. (Search for BehaviorAdvisor.com when you’re logged in to facebook.)

Warm regards,
Dr. Mac

 Posted by at 11:03 pm
Feb 142021
 

(The Behavior List)

 

Hello again, everyone!  It’s nice to be back with our B-Lister group after such a long hiatus since our last gathering.  Remember that you can find those long-lost e-mail blasts at http://www.behavioradvisor.com/blog-3/ , what-to-do and how-to-do-it posts on kids who are labelled as having O.D.D., Conduct Disorder, Generalized Anxiety Disorder, PTSD, Autism Spectrum Disorder, and ADHD.  You’ll also find video case studies of kids who display a number of DSM-5 disorders.

But that’s the past.  Here’s the present…

Today I have the professional pleasure and privilege of bringing a special educational treat.  It’s a goodie for those of you who work with students who often-times display “reactionary” behaviors to what seems to us to be rather innocuous circumstances.  What causes a learner to “shut down” and withdraw into oneself, or “tense up” and strike out verbally or physically?  What’s going on behind the “function” (the cause, reason, or purpose) of the persistent response pattern that we’ve identified with our Functional Behavior Assessment (FBA) procedures?

 

I’m now joined by Simon Currigan, well-known purveyor of behavior management wisdom at the Beacon School Support website (beaconschoolsupport.co.uk).  His frequent postings provide sage advice on how to bolster your skills for reaching and teaching children and youth with mental health and behavioral challenges.

 

    

 

Tom: Good day, Simon!  Thank you kindly for visiting with us today.  On behalf of our BehaviorAdvisor.com “B-Listers” I’d like to chat with you about a cause of challenging classroom behaviour that is often overlooked; a topic that is receiving increasing attention in the professional research literature, but might not have made its way to classroom application quite yet.  But before we delve into that compelling subject matter, please introduce yourself to people who are unfamiliar with your full-of-advice website.  What’s your professional background, and how did you come to be a sought-after consultant who supports schools in their efforts to better serve students with behavior disorders?

 

Simon: Well, it wasn’t a career path I planned, exactly.  I studied Computer Science originally and worked as a programmer before taking the next natural step of training to become a school teacher!

Joking aside, those two careers are related in one sense:  I’ve always been interested in taking things apart and finding out how they work.  Computing is about understanding how systems work in the real world and modelling them in software.  Education is understanding how systems in the mind work.

 

Tom: When did you move from the inclusive classroom to special education with troubled and troubling kids?

 

Simon: After about 8 years in mainstream, a colleague of mine mentioned I had strong behaviour management skills, and related well with “difficult kids”.  He recommended I apply for a position in a pupil referral unit.

 

Tom: I’m unfamiliar with that term, Simon.

 

Simon: In the UK, these are small schools where students are sent when their severe behaviors result in them being permanently excluded from their mainstream school.  The kids all bring significant challenges in terms of mental health issues, behaviour, aggression, and their emotional well-being.  While designed to provide needed services and supports, when a large group of children and youth with these issues are placed together, educators need to possess a certain type of demeanor and set of skills in order to prevent the lighting of the fuse to an emotional powder keg! 

At this point in my career, I started learning a lot more about the deeper causes of behaviour, and finding ways to place that psychology and behavioural science into practical use in the classroom.

 

Tom: Yes, we have a strong and constantly increasing knowledge base, but those ideas don’t  always work  with the same degree of effectiveness as stated in the textbooks… especially with young people who possess severe emotional and behavioral challenges.

 

Simon: That’s the truth! Then after about six years of working in the classroom, I made the jump to running the unit, and from there to supporting schools back in mainstream, with the hope of preventing pupils getting kicked out of mainstream schools to the referral units in the first place.

 

Tom: You’ve got the credibility, Simon.  You mentioned earlier the application of psychology and behavioral science to classroom teaching with learners who display errant reaction patterns.  So, that’s the area of interest that we’re going to look at today?  What’s this often-overlooked cause of over-reactive classroom behavior?

 

Simon: The impact of stress on human behaviour.  Full credit to Dr. Stuart Shanker   here – his work in this field has had a huge impact on me.

 

Tom: We certainly read and hear a great deal about stress, but how does its presence apply to students who display inappropriate… inappropriate in the classroom…response patterns?  And what do you mean by stress, exactly?

 

Simon: I mean stress in the biological sense – any pressure, internal or external, that causes our bodies to start producing stress chemicals like adrenalin, noradrenalin and cortisol – and make us burn more calories.  These changes are important because they affect how our brains operate – and limit the kinds of behaviour choices our brains have available.

It kind of boils down to this:  When kids feel calm, happy and confident in the classroom, learning happens naturally.  Even for the most challenging of pupils.

But when those same students are under stress, all that changes.  And I don’t think that we – as adults – appreciate how stressed some of our young people in our classrooms are.

 

Tom: What are the sources of that stress – in the classroom?

 

Simon: Well, that depends on the individual student.  We’re all different.

For some kids, that stress might be related to sensory needs.  When our senses are unbalanced, our bodies spend a lot of energy trying to compensate, which results in additional stress.

For others, attachment issues may mean they feel unsafe, are constantly on-guard for threats to their psychological and/or physical safety, and prepared to immediately fend for themselves if they perceive potential peril – and that’s made worse in large group situations.  Some pupils may maintain high stress levels due to anxiety, or have difficulty understanding social interaction – and schools are full of complex social interactions – which results in…

 

Tom: Stress?

 

Simon: Okay. So I’m getting predictable!

 

Tom: Why does this building up of stress matter to us as educators?

 

Simon: Well, stress changes the way humans think and act.  In our day-to-day lives – and I’m putting survival situations to one side here – our brains have access to three types of behaviour; logical, emotional and automatic.  And those are all driven by different parts of the brain.

But the more stressed we get, the less influence our prefrontal cortex has on our behaviour and decision making.  And I’m sure your students know about the role of the prefrontal cortex.

 

Tom: Mine do, but for others who haven’t studied this material, it deals with rational thinking, executive functioning, logic, inhibition, planning, prioritizing, thinking about long-term goals…

 

Simon: Exactly.  So, if we want kids to use those skills, we need them to be emotionally calm.

Let’s take an example student.  We’ll call him Gavin.  Gavin has sensory needs, difficulties with receptive language and issues around perfectionism.  His mentor has given him a strategy to follow when there are misunderstandings, he makes a mistake, or sensory input causes him distress: Go to a time out area, do some deep breathing, and clear the mind.

Here’s the impact of stress…  On Day One he walks into a classroom where he feels like the teacher doesn’t like him.  The sunlight streaming through the window shines directly on him and the teacher reads out the test instructions quickly.  Gavin immediately feels under pressure and he’s scared he’s going to make a mistake.

Each of these factors are going to increase Gavin’s stress levels.  The sunlight, the poor relationship with the adult, the test, processing the instructions.  Biologically, his stress goes sky high.

So he loses access to the prefrontal cortex; all those executive and self-control skills.  All he’s left with are the emotional or automatic behaviour options.

Tom: So then you might witness an emotionally-charged behavior, like an outburst.     

Simon: Absolutely – because that might be a strategy that’s been successful for Gavin previously.  Or he might display an automatic behaviour that’s been successful for him in the past, like refusing the test or ripping it up, and he just replays that.

And I don’t mean successful in terms of academic success, or following strategies suggested by the adults.  This is success from his body’s perspective, which wants to escape the current stressful situation he’s trapped in.  His biological state will focus him very much on the ‘now’; survival in the moment.

 

Tom: So the stress or a perception of a threat to his psychological safety might result in a fight or flight response, like walking out of class, or…

 

Simon: That’s right.  Or being aggressive towards the teacher – or the other kids.  Or whatever.

 

Tom: In educational psychology those actions are said to be maladaptive.  A short-term survival strategy that works against you in the long-term.

 

Simon: In this high-stress state, he can’t access that type of long-term, logical thinking.  So when the adults give him reminders about his targets or strategies – or which consequence will be administered down the line if the behaviour continues – it won’t have much effect in that moment.

 

Tom: So what can we do when we’re in a situation with an emotionally-charged student whose rational-thinking pre-frontal lobe has shut down?

 

Simon: Let’s take another example. 

It’s Day Two. Gavin walks into the same classroom, but it’s a different teacher – one he has a good relationship with.  The sun is still bright, but his teacher pulls down one of the shades or tells Gavin he can move out of the direct sunlight if he wants to.

The teacher still hands out an unexpected test, but this time, puts a photocopy of the instructions on Gavin’s desk so he can read and process them in his own time.

 

Tom: Each of these actions is either preventing or reducing Gavin’s stress levels.

 

Simon: It’s like a see-saw.  Gavin’s stress levels will still go up, because of the test.  But his teacher is also taking stress out of the system, wherever possible, to compensate, lowering the see-saw down in the opposite direction.  And a big protector here is going to be Gavin’s relationship with the teacher.

 

Tom: In my mind, building and maintaining positive student-teacher trust bonds is THE crucial component to working productively with intervention-resistant kids.  We’ll see more progress with kids like Gavin when they feel like the we’re on their side, keeping their welfare in our hearts and minds.

 

Simon: And that’s going to make him feel more relaxed – even protected.  Lower stress means Gavin can still engage in emotional, automatic AND logical behaviours.  I think this is why good relationships are the cornerstone of classroom management.

 

Tom: The kids feel like you’re acting in their best interests, keeping them safe.  Okay – what about automatic behaviors?  In the first example, Gavin’s automatic behaviors for the test were all negative… maladaptive.  What approaches have you seen work to replace those behavioral errors?

 

Simon: Well, I think it’s a big mistake – and I see this often – to give your student a strategy, talk it over once and twice, and walk away as if it’s a case of job done.  There’s a big gap between knowing what to do – and actually doing it.  The world’s full of overweight people who know what’s good for them – they should eat less and exercise more – they just don’t do it.  No judgement here – I’m one of them!

Truth is, if we want a behaviour to become automatic, we have to do more than that.  We have to help our kids rehearse the behaviour, over and over; experience being in that stressful situation and then act in a positive way. 

So we expose them to the trigger – the thing that’s causing them stress – but then we practise the positive behaviour in response to that trigger.

 

Tom: Spot on, Simon.  Teaching is more than telling.  If kids are going to display a replacement behavior under pressure, they need to practice it in progressively more realistic hypothetical situations.  That role-playing desensitizes them to the stressors and provides a new response that adequately addresses the stressful situations.  I’m guessing that positive reinforcers for effort and progress are included too.  Yes?

 

Simon: Tom – you’re one step ahead of me!  We follow up with a reward, to encourage that response in the future. That reinforcer doesn’t have to be anything big – it could be praise, a high-five, a sticker on a chart.  My mantra is: Whatever works for the child.  They’re all individuals.

And then – as they say in the gym – it’s doing reps and sets.  This is the bit that gets missed in busy classrooms and schools.  Repeating and practising that trigger and response multiple times daily with the pupil, until it becomes automatic.  Coaching them through.  It doesn’t have to take long, you might be able to practise the trigger and response 5 times in a five-minute session.  Then it’s a case of scheduling that five-minute session every day, or twice a day, or whatever’s needed.

 

Tom: So, when our learners get stressed, they’ve got a newly ingrained automatic behavior they can use to better resolve the situations – instead of resorting to the old, maladaptive one.

 

Simon: Absolutely.  We’re hitting the problem from both sides – we’re reducing the factors that cause the stress in the first place, but then replacing the old automatic behaviours with positive ones. Now our student can cope positively and prosocially when those stressful situations come up.  We rehearse that new behaviour until it becomes second-nature.

It’s interesting because, we know from research that the power of the prefrontal cortex to use self-restraint and logic decreases when under pressure – but under that exact same pressure, automatic behaviours actually become more powerful.

 

Tom: In your experience, how long does this training process take? How long before the student is able to display the new automatic behavior when the situation calls for it?

 

Simon: There’s no simple answer to that question.  Depends on the child, depends on the behaviour.  It also depends on how complex the new behaviour is – if it’s simple, it makes it easier to learn. If it’s complex and involves lots of steps, it’s more difficult to make it stick.

And it also depends on the willingness of the student you’re working with.  If they actively don’t want to change, then no amount of persuasion or repetition is going to work.  It’s like your motto, if you want to…

 

Tom: …teach them, you gotta reach them.  We can use an “evidence-based” intervention with fidelity, but if the student isn’t willing to engage in that process with us, it’s not going to work like it did in the research studies.  I believe that takes us back to an earlier essential point.

 

Simon: Exactly.  We’re back to relationships.  You can’t help someone change if they don’t want to change.  Fortunately, most kids – especially younger ones – are willing to accept the help and see the benefits.

 

Tom: And our older learners with severe acting-out behavior patterns, the ones who are sent to deeper and more intensive levels of special services, almost without exception bring with them a history of myriad bad experiences with educators. Even though our intent is to “expel them to better places”, they’re initially quite suspicious of our motives, especially in anxiety-producing situations.  Simon, I’m not telling you anything you don’t already know when I say that we need to prove ourselves as being different than their expectations for us.  We get to that trustworthy point by using “symptom separation”… working diligently to dissolve and replace the aberrant actions, all the while unswervingly supporting those learners; expressing our belief in their ability to make better behavior choices, and strengthening their faith in the student-teacher trust bonds we’re striving to build with them.  Quite simply; They gotta like the messenger if they’re going to listen to the message.

That brings us back to your vital messages today, Simon. You’ve given us a lot of food for thought regarding the impact and addressing of the stress that our kids with disruptive behavior disorders are experiencing.  How can our readers find out more about these ideas and other knowledge points and skill sets that bring success with our students with behavior challenges?

 

Simon: Well, we’ve got lots of free resources and articles on our website beaconschoolsupport.co.uk – where we always try to join the dots between theory and classroom practice.  Just click on the free resources tab to access them.  And if you’re particularly interested in the impact of stress, I’d also recommend you look at the books and training Stuart Shanker produced around self-regulation.  They’re super-clear and actionable.

 

Tom: I’ve viewed all those freebie materials on your site and read your information-packed e-mail blasts.  Great stuff. For folks reading the transcription of our conversation, let me mention to you fine folks that Simon’s materials are full of what-to-do and how-to-do-it behavior management tips. 

Thanks, my cyber-colleague, for accepting the invitation to talk a bit about how stress impacts our young learners’ ability to focus, calm themselves, and self-manage their actions.  Thanks too for the tips regarding how we can best serve these young people.

Simon, it’s been a pleasure chatting with you.  One last time; Thank you for joining us today!

 

Simon: Good to speak to you too, Tom!

 

 

 

The ONLY book written FOR kids with Disruptive Behavior Disorders!

Great for your classroom library or SEL/Social Skills groups.

Available at https://www.freespirit.com/gifted-and-special-education/survival-guide-for-kids-with-behavior-challenges-thomas-mcintyre/

 

 

 

 

 

 

 

 

 

 

Sep 222018
 

 

Conduct Disorder

 Manipulative, aggressive, defiant, disobedient, victimizes others without empathy for them, violating community codes, and more!  But enough about my colleagues; let’s talk about the kids who have an intervention-resistant condition known as conduct disorder.

Definition of “Conduct Disorder” (from the Diagnostic & Statistical Manual, DSM-5 of the American Psychiatric Association, AND the International Classification of Diseases – ICD 10): When the leader of the orchestra directs the musicians to play Beethoven’s 9th symphony to the beat of Macarena using only piccolos and cowbells.  Oh wait… that’s Conductor Disorder (I hear that it’s being considered for inclusion in the 2050 12th editions of DSM and ICD.)

*If you’d like to know about the history of the DSM, the holy book of mental health professionals, view my rather irreverent video podcast on the topic.

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Conduct Disorder

Hello again, fellow B-Lister! Tell me: Does the delivery of this weekly newsletter seem like a cruel and callous act aimed directly at you?  If so, either I have a Conduct Disorder or you suffer from Paranoid Schizophrenia. Let’s assume the former.  (It’s not paranoia when they really ARE after you.)

Conduct Disorder (CD) is one the most pronounced, in-your-face, and intervention-resistant of the school-age diagnoses in the manual of mental illnesses.  It expresses itself in major violations of age-appropriate social expectations   I have a great deal of direct experience in self-contained classrooms chock-full of pre-teens & teenagers with this label.  (Although Conduct Disorder can appear as early as the pre-kindergarten years!)  Those days were memorable, and provide lots of stories for “I can beat that one.” story-telling competitions at conference’s end-of-day pubs.

In my early experience, I remember being anxiously alert even during CD’s inactive stage when the kids were on-task and cooperative.  Often I could sense an odd, undefined psychological undertone then made me feel tense and anxious… a harbinger of what was to come.  You see, many of my kids were like behavioral popcorn; you knew they were going to explode…

  You just didn’t know when. 

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It was akin to placing your ear to the train tracks…  

You know something’s coming, but you don’t know from which direction.

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Then you realize; the express train is coming!

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In its activated state, Conduct Disorder is one of the most frightening of disorders with which to be confronted… filled with terrible negative chi (energy).  Indeed, “confront” might be the operational word here.  When CD presents itself in its full-force, you better be on top of your professional game.

Fear not!   You can reach that point with the strategies found on my  BehaviorAdvisor.com and other fine sites. 

This posting will direct you to those essential resources.

First though, let’s wrap our brain around this psychological malstrom.  In an earlier B-list blast, we addressed ODD; Oppositional Defiant Disorder.  These youngsters exhibit a persistent pattern of disobedient, argumentative, defiant and hostile actions.

 

Like “Henry” in one of the videos found below, these youngsters are at great risk for transforming into someone with a more severe condition: Conduct Disorder.  Generally speaking, kids with the ODD diagnosis do not demonstrate the mean, cruel behavior found in the diagnostic criteria for Conduct Disorder. 

The CD diagnosis is made when the youngster presents a prolonged pattern of antisocial behaviour such as serious violation of laws, social norms and rules.  Our students with Conduct Disorder are the quick-tempered, non-empathetic, acting out kids who bully and threaten others,

   

solve their disputes with fearless violent physicality, destroy property, steal, lie, engage in drugs and alcohol, etc.

They break the rules, regulations and juvenile codes of society,  and violate the basic rights of others, sometimes in a callous and cruel manner, and disobey regulations in the home; staying out past curfew or running away (among other actions).   The condition is highly intervention-resistant.

CD recidivism

The DSM-5 retained the critical points from its previous edition’s criteria (DSM-IVtr), and added a “specifier” regarding the Conduct Disorder diagnosis that is intended to differentiate between impulsive acts of rage due to emotional overload in the youngster, and those acts that are planned in a calculated manner before engaging in them.  The latter type are identified by DSM’s “Limited prosocial emotions” clause (see below).

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Diagnostic Criteria for Conduct Disorder

According to the , in order to diagnose Conduct Disorder, least four of the following traits must be present:

  • Aggressive behavior toward others and animals.
  • Frequent physical altercations with others.
  • Use of a weapon to harm others.
  • Deliberately physically cruel to other people.
  • Deliberately physically cruel to animals.
  • Involvement in confrontational economic order crime- e.g., mugging.
  • Has perpetrated a forcible sex act on another.
  • Property destruction by arson.
  • Property destruction by other means.
  • Has engaged in non-confrontational economic order crime- e.g., breaking and entering.
  • Has engaged in non-confrontational retail theft, e.g., shoplifting.
  • Disregarded parent’s curfew prior to age 13.
  • Has run away from home at least two times.
  • Has been truant before age 13.

The preceding criteria is accompanied by the following:

1. The behaviors cause significant impairment in functioning and

2. If the individual over age 18 the criteria for APD is not met.

           Further qualifiers are:

1. Child, Adolescent, or Unspecified onset.

2 Limited prosocial emotions, – lack of remorse or guilt, lack of empathy, callousness, unconcerned about performance, shallow or deficient affect.

3. With mild, moderate, or severe levels of severity (American Psychiatric Association, 2013).

For more information on associated factors, visit https://www.theravive.com/therapedia/conduct-disorder-dsm–5-312.81-(f91.1),-312.82-(f91.2),-and-312.89-(f91.9)

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It is hoped (by the American Psychiatric Association) that the “limited prosocial emotions” qualification will separate “cold blooded” versus “hot blooded” behavior; ruthlessness  versus rageemotional versus evil.  McCauley Caulkin’s character in the film titled “The Good Son.” (Dr. Mac’s compilation of scenes) shows this latter behavioral motive at its cinematic extreme.  He is removed, unemotional, and callously cruel. 

For a less dramatic, more realistic depiction, take a look at these videos that were created by my wonderful graduate students in our behavior disorders teacher-training program at Hunter College (of the City University of New York… the 3rd largest university system in the United States). 

Here are the links to case study videos:

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Teachers talk about teaching kids with Conduct Disorder

  1.  Dr. Mac is interviewed after being announced as a recipient of the MSLBD Janus Award (for significant contributions to the field of teaching students with mental health and behavior disorders): (part 1, 8 minutes) https://youtu.be/PTwVSrRcu7g  &  (part 2, 9 minutes) https://www.youtube.com/watch?v=tuBc-ldgIY0
  2. Dr. Mac interviews Tony Mullen, the U.S National Teacher of the Year  (Audio) 

9-Part (80 minute) Interview with Anthony Mullen, National Teacher of the Year (USA). He is a teacher of urban students with severe emotional & behavioral disorders (EBD). (Tony is on the left in picture. Dr. Mac is on the right.)

#1 (8:15) Introduction and general overview

#2 (9:30) Building relationships with relationship-resistant youngsters

#3 (6:26) How he built strong trust bonds with one authority-aversive student

#4 (6:09) The use of humor & Helping students reach high standards

#5 (8:26) Forces that work against caring and competent teachers of EBD students

#6 (12:16) Models for reaching and teaching EBD students, Behavior management, Tips for new teachers, and reaching out to the homes of students with EBD

#7 (12:30) Teaching social skills & Use of cooperative groups with EBD students

#8 (9:52) Misbehavior as a test of the teacher & How to pass the tests our students give

#9 (9:09) Closure & Fond recollections of his teaching experience

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The ways that Conduct Disorder plays out on the urban poverty area streetcorner

Becoming streetsmart: Understanding and defusing the manipulative and aggressive tactics of urban streetcorner youth

Respecting and reaching streetwise kids

.How did they come to be this way? 

It is important to note that Conduct Disorder is rarely a conscious choice, at least initially.  While the jury is still out regarding the etiology and the extent to which nature and nurture intertwine, for the most part the source for this aberrant behavior, distorted value system, and negative character is believed to emanate from one primary source.  Typically, it is a lifestyle that develops due to the home/neighborhood environment in which these youngsters live.  As one example, a national office in the United Kingdom states that 40% of kids who were maltreated/abused by adults in their lives developed conduct disorder.  Others may be emulating the behavior they witnessed in their homes/neighborhoods.  In any case, one’s moral code and value system is maladapted to success in school and mainstream society.

Research shows that Conduct Disorder is frequently associated with the following factors; each of which increases risk for the aberrant behavior pattern:

  • Smoking & alcohol use during pregnancy
  • Abusive child-raising practices
  • Inadequate supervision
  • Inconsistent disciplinary measures
  • Parental drug abuse and alcohol addiction
  • Homes filled with familial conflict
  • Single parent household
  • Young age of mother
  • Large family size
  • Divorce in the family
  • Living in areas of long-term, ingrained poverty

*! It is important to remember that the vast majority of kids who grow up in these circumstances do NOT develop Conduct Disorder.  However, these factors, especially in combination, do increase the risk of development.

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There might also be a biological component, as having Attention Deficit Hyperactivity Disorder (ADHD) increases the risk for developing CD, and an as-of-yet unidentified genetic component is also a possibility.  Indeed, one study found children adopted from parents with anti-social personality disorder (the adult version of Conduct Disorder) having a higher incidence of aggression than children adopted from parents who did not have anti-social personality characteristics.

It is common for kids with CD, especially those with early onset of the condition, to have impaired cognitive functions and intelligence.  This outcome may be the result of differences in brain anatomy and function, as youth with CD are more likely to have reduced responses in areas of the brain that are associated with interpersonal social actions and emotional responses (i.e., amygdala, insula, orbito-frontal cortex, and ventro-medial prefrontal cortex…. Whew!…That’s enough… My tongue gets dizzy just trying to say all those neuro-names).

How many kids have CD? 

It is difficult to assess the prevalence of the disorder because of the varied interpretations of the criteria for the diagnosis (e.g., “defiant”, “rule breaking”).  Additionally, the more international ICD manual uses a slightly different categorization system.   I guess that it’s akin to the difference between art and pornography; difficult to define, but you know it when you see it. (Some folks seem to see it more so than others.)

Consider the “epidemic” proportions of children with autism.  The latest estimates are 1 in 90 children up to 1 in 58.  Then consider the most common estimate for the number of kids with conduct disorder: 1 in 7(Although estimates range from 1% to 10%, with a median guestimate of 4%.)  My intent is not to demean or downplay the need to address autism.  Rather, my intent is to show the unequal power of the parental/professional bases, and public perceptions of the two conditions.

 

CD signs

ICD (International Classification of Diseases from the World Health Organization) has a section on mental health disorders that is an equivalent text to DSM.

 

 We also know that the diagnosis is more common among boys (estimated to be about 9% of young males), but girls (estimated at 2% of that gender) are certainly not immune.  The lesser estimate for females is sometimes attributed, in part, to the diagnostic criteria that tends to focus more on acting out behaviors which tend to be more common among males.

There are also racial disparities in diagnosis, with kids whose ancestry is from sub-Saharan Africa at greatest risk for diagnosis.  Kids of east-Asian ancestry appear to be at least risk. (Although, again, they are not immune.)

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INTERESTING (to me) FACT:  When the U.S. passed P.L. 94-142, The Education of All Handicapped Children Act (now Individuals with Disabilities Act), a committee was formed to define the educational disability label of “seriously emotionally disturbed” (now “emotionally disturbed).  It was led by Eli Bower.  Not surprisingly, the definition from a book he authored became the one that would be used in schools.  It contained five criteria “… 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 child’s educational performance:

A. An inability to learn that cannot be explained by intellectual, sensory or health factors;

B. An inability to build or maintain satisfactory interpersonal relationships with peers and teachers;

C. Inappropriate types of behavior or feelings under normal circumstances;

D. A general pervasive mood of unhappiness or depression;

or E. A tendency to develop physical symptoms or fears associated with personal or school problems. The term includes schizophrenia. The term does not apply to children who are socially maladjusted, unless it is determined that they have an emotional disturbance (ED).

That last sentence (in red) has caused confusion since that time.  First, there is no general agreement as to the definition of “socially maladjusted”.  What does this term encompass?  The most common definition is to equate it with DSM’s “Conduct Disorder”.  Second, why wouldn’t we wish to serve and reclaim these youth? Third, Eli Bower wrote an article in the mid 1990s stating that he had no idea where that final sentence came from!  When the definition left his committee, it was not part of the definition.  Yet when the regulations interpreting the new law were published, it was there.  It appears that some unknown bureaucrat slipped it into the definition when no one was looking.

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Let’s Reclaim These Kids! 

Here are some quick tips and approaches.  You’ll see some new ideas at the end of the lists, although most will be reiterations approaches and interventions for youngsters with ODD.  That’s to be expected though, as I used to be the director of the Department of Redundancy Department.  (Have I told that joke before?  If so, you now understand why… again.)

Educators

1. Don’t give directions.  Huh?! (That’s “Eh” for our Canadian readers.)  Yes, I realize that adults in authority see it as their duty, but with these kids you’re charging into the same valley as the 600.  Unlike the Light Brigade, ours IS to reason why, and if doomed to failure, decide on another course of action.

What then do we do?  Ask questions!  It hard to refuse a direction if it isn’t given!  Here are some examples:

“Atsa, where should your tush (Yiddish for “buttocks”) be?” (“In the chair.”) “Good thinking.”

“Kialani, when is the time for outside voices?” (“Recess.”) 

“Which voice level do we use during partner work?” (“Our six inch voice.”)  Teacher nods.

“Ebony, when is the time for learning centers?” (“Later.) “Thanks for returning to your seat.” (Pre-correction praise.)

“Wei, when the bell rings, where should students be?” (“In our seats.” as he then walks in that direction)

Note that the questions NEVER use “Why”.  That’s because that word can sound accusatory, setting off an angry and threatening self-defense strategy.

More information on how to entice students into cooperating can be found at – http://behavioradvisor.com/Webinar.html

2. Make use of strong, research-supported, positive interventions

2a. Differential reinforcement: It’s a twenty dollar term for a one dollar idea, but the different variations of the DR procedure are highly effective with intervention resistant kids

.2b. Self monitoring: Promote self-regulation of behaviour by having the student keep track of his/her behavior..

3. Pick up additional defiance-defusing tips.

4. Teach problem solving skills to devise alternative solutions to anger and rebellion.

5. Modify the character of the youngster using the Circle of Courage model of intervention.

6.  Determine the present level of readiness to change behaviour, and move the youngster toward greater levels of willingness to change his /her behavior for the better.

7a.  Use “The Behavior Survival Guide for Kids: How to make good choices and stay out of trouble”  in your social skills/anger management programs, or place it in the class library.

7b. Implement the FREE 100+ lesson plans that accompany The Behavior Survival Guide (or use them in isolation)

8. Engage the youngster in Multi-Systematic Training (MST: http://mstservices.com/index.php/what-is-mst)

9.  For girls who tend to me more responsive to peer-influence and empathy-based interventions than boys, provide this intervention focus.

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Parents

1. Develop a home-school behavior change program based on the monetary system.

2. Learn the principles of changing behaviour for the better, and effective strategies for helping your child make better behavior choices.

3.  Leave “The Behavior Survival Guide for Kids: How to make good choices and stay out of trouble”  out on the coffee table for your child to pick up.

4. Seek out family counseling.

5. If your child is engaging in drug abuse, seek out drug-exit programs.  One research study showed that 1/2 of drug users with conduct disorder no longer exhibited the disorder when free of illicit substances.

6. For girls who tend to be more responsive to peer-influence and empathy-based interventions than boys, adopt this intervention focus.

 

NEXT WEEK (or maybe two): Childhood Depression (sometimes associated with CD)

 

 

Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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  Liking these weekly B-List Blasts? 

 Buy Dr. Mac a Cup of Coffee! Dr Mac - CupOfCoffee (Click on the cup for info) (or go to paypal at Doctormac@BehaviorAdvisor.com to say “Thanks“.)

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Sep 222018
 

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Next week: Conduct Disorder (Kids who lack empathy for others, use aggression and manipulation, violate youth community ordinances, etc.)

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G’DAY FELLOW B-LISTERS!!  Yet again this week, we continue with our write-ups and (free) videos regarding DSM-5 diagnoses that are found in the records of our students identified as having mental health and/or behavio(u)ral disabilities.

This week, we look at the “The Spectrum”.  The “Autism Spectrum Disorder” is a range or continuum of neurological conditions that develop early in childhood (before age 2) and continue for the remainder of life. These youngsters typically display abnormalities that result in in social communication and interaction impairments, repetitiveness of behaviors, and limited interests or activities.

Depending on which article you read, you’ll see one of two explanations of “the spectrum”.  The first explanation is that “ASD” is an umbrella term covering five distinct conditions (the olive colored ovals in the image above): Autism, Asperger Syndrome, Rett Syndrome, Childhood Disintegrative Disorder and Pervasive Developmental Disorder Not Otherwise Specified (PDD-NOS).  The latter term is assigned when the youngster’s symptoms don’t fully meet one of the other four diagnoses, but the characteristics are highly similar and s/he definitely has social, behavioral, and communication needs requiring special services.  The second explanation is that ASD is itself under a larger umbrella, and that Pervasive Developmental Disorders is the all-inclusive label, with ASD covering the 3 diagnoses seen in the diagram above.

Whenever we discuss “kids on the spectrum”, the conversation moves toward discussions of which is the best way to help kids with ASD develop better ways to handle life’s situations.  Is it the highly structured ABA practices? The “loose” and spontaneous interpersonal Floor time intervention?  The CABO approach?  Does a change in diet reduce the symptoms?

Another discussion point involves the “overrepresentation” (higher percentage than we would expect given the % of the total population) of kids identified as “white”.  Is there something about the genetics or lifestyle/diet of European heritage pregnant females that places their children more at risk for ASD?  Or could the underrepresentation of some groups be due to issues with regard to diagnosis and service provision? 

Either way, our discussions are quite far removed from the consideration of the 1940 to 1960’s view by Kanner and Bettelheim that autism was a result of cold and unemotional parenting by “refrigerator parents”, the 1970′ to 1980’s when the inside (bad) jokes among educators and psychologists included that the child should be diagnosed with “FLK Syndrome” (Funny-Looking Kid Syndrome) or “Pain-in-the-Asperger Syndrome”, Breggin’s 1990’s return to the emotionally cold trauma-inducing refrigerator parent theory (That theory is still widely held in France, other parts of Europe, and South Korea.), or the now disproven early-2000’s idea that a preservative in early childhood inoculations brought on the condition.

Regarding the questionable material in the previous sentence; I don’t want to shield professionals in our micro-field from our history, be it good or bad.  Our history has warts on it.  Knowing this material helps us to defuse misguided understandings and handle errant attempts at humor when they surface (and they still do).

 We can expect the field to further change and gain precision in diagnosis and service/supports.  It’s yet another reason that teachers need to keep up with the professional literature, or subscribe to free sites that distribute summations. (BehaviorAdvisor.com on facebook, School Psyched-Your School Psychologist on facebook, and the CEC Smartbrief at  http://www2.smartbrief.com/signupSystem/subscribe.action?pageSequence=1&briefName=specialed&utm_source=brief

How many youngsters have Autism?

The number of youngsters with autism around the world continues to increase.  According to the Centers for Disease Control and Prevention (CDC) in the U.S. (March-April, 2013), it is estimated that 1 in 88 American children has some variation or degree of autism.  That is an increase of nearly 80% compared to just a decade earlier.  Now the estimates state that 1 in 68 children is “on the spectrum”.

How was this finding determined?  Since 2000, the CDC’s Autism and Developmental Disabilities Monitoring Network has based its estimates on a bi-annual counting of how many 8-year-olds in about a dozen communities across the nation have autism. (The number of sites has ranged from 6 to 14 over the years, depending on the availability of funding in a particular year.)

In 2000 and 2002, the autism estimate was about 1 in 150 children. Two years later 1 in 125 of the 8-year-olds had autism. In 2006, the number was 1 in 110, and in 2008 — 1 in 88 children had the condition.  Estimates from later studies cite 1 in 68 children are involved.

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Boys with autism continue to outnumber girls 5-to-1, according to the CDC reports. It estimates that 1 in 54 boys in the United States have autism to some degree.

Note: As of May 2013, Aspergers syndrome was no longer be recognized as a condition separate from autism.  The youngsters who have the symptoms of this now defunct condition will be labeled as having autism.

 

What are the signs & symptoms of Autism?

In general, kids with autism have a neurodevelopment disorder (brain neurology-biology complications) that leads to impaired language abilities, difficulties in inter-personal communication, and under-developed social skills. The videos found below will answer this sub-title question in more depth.

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 Intervention and strategies

Well-conducted research studies show that the earlier the implementation of effective the interventions, the better the long-term outcomes for kids on the autistic spectrum.  Of course, early intervention is dependent on early identification of the disorder. The videos (below) discuss some of those approaches.

 This week, in addition to the videos by my wonderful graduate students, I include other pertinent and essential information.

CASE STUDY VIDEOS

These vids provide a case history of a child, compares his/her characteristices to the identification criteria

in the Diagnostic and Prescriptive Manual of the American Psychiatric Association (DSM-5)

1. Autism overview (DSM-5) criteria – https://www.youtube.com/watch?v=3RG4oJ51PTw

2. Connor, a 7 year old boy with Autism (DSM-5 criteria)  – Part 1  and  Part 2

3. “Sally”, a 10 year old girl with (as it is known in April 2013, DSM-4tr criteria) Autism. Part 1 …. Part 2

4. 2-part case study video regarding Aspergers Syndrome:  https://youtu.be/BJP9AoyU34o and https://youtu.be/R9tEej7qS5k

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INTERVENTION VIDEOS

These videos & documents describe the various approaches and strategies

5. (Overview of ASD and) ABA Therapy – https://youtu.be/RBB_81ao7uo

6. The DRI-Floor Time model (Overview & case study) – https://www.youtube.com/watch?v=enRX7Nu2j8E  (For more information, search for “Floortime” on youtube)

7. Zones of Regulation (teaching self-control to students on the spectrum) – https://www.youtube.com/watch?v=RK834FbWA4o

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OTHER STUFF

8.What is Sensory Integration Disorder? (Often reported in kids “on the spectrum”) – http://www.behavioradvisor.com/SID.html

9.  About “sensory rooms” & “sensory therapy” (Often recommended for kids “on the spectrum”) – Read the second column on page 21 (right side page of the two pages) at: http://www.pageturnpro.com/Midwest-Symposium-for-Leadership-in-Behavior-Disorders/81890-Rethinking-Behavior/default.html#page/23

 10. Characteristics of Quality Programs for Youngsters on the Autistic Spectrum (Checklist) – Click here 

11. Fifteen general strategies for working with students with ASD – Click here

12. General strategies for addressing different characteristics common among students with ASD – Click here

13. Research proven practices (and unproven) –  AutismEffectivePractices.pdf

14. Differential Reinforcement; powerful and positive behavior change procedures

15. FreeSpirit.com has a self-help book for kids with autism titled “The survival guide for kids with Autism Spectrum Disorders (and their parents)“. (and Dr. Mac’s book for kids with acting out behaviors)

 

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Next week: Conduct Disorder 

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

.

.

  Liking these weekly B-List Blasts? 

 Buy Dr. Mac a Cup of Coffee! Dr Mac - CupOfCoffee (Click on the cup for info) (or go to paypal at Doctormac@BehaviorAdvisor.com to say “Thanks“.)

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Sep 082018
 

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HELLO FELLOW B-LISTERS!!  Again this week, we continue with our write-ups and (free) videos regarding DSM-5 diagnoses that are found in the records of our students identified as having mental health and/or behavio(u)ral disabilities.

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This week, we look at the hyper-alert, guarded, and varied fear-based reactions that have their source in traumatic events that happened in one’s past (or may be continuing into the present).  Nowadays, that trauma is referred to as ACEs (Adverse Childhood Experiences) or ELA (Early Life Adversity).  

           

This week’s videos (made by a couple of my super grad students in our teacher training program in the area of mental health & behavior disabilities) serve well for short staff professional development sessions.  Professors can make use of them in education or psychology classes.  Parents of children/youth with PTSD become more informed regarding their loved ones condition and how it can be addressed.  Please spread the informational  wealth! 

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Each video will provide you with a case study of a hypothetical youngster.  Then the characteristics of that child will be compared to the diagnostic criteria of the DSM-5 diagnostic manual structure for that disorder.  That part is then followed by suggestions for intervention.

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REVIEW: All anxiety disorders have the same derivation: An irrational (to others) fear of something; a perception of a threat to their physical or psychological comfort/safety.

 

 

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PTSD (Post Tramatic Stress Disorder in children) can be defined as “an anxiety disorder that develops after exposure to a terrifying event or ordeal in which grave physical harm occurred, was observed, or was threatened.” Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, exposure to warfare, forced and/or difficult migration, accidents, or lack of sustinence or positive support in the home, among other harrowing events (singular or recurring).

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In the words found in the DSM-5 Psychiatric Manual: “PTSD is an anxiety disorder that develops in relation to an event which creates psychological trauma in response to actual or threatened death, serious injury, or sexual violation. The exposure must involve directly experiencing the event, witnessing the event in person, learning of an actual or threatened death of a close family member or friend, or repeated first-hand, extreme exposure to the details of the event.”

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Here are the videos on PTSD as it relates to children and youth:

1. https://www.youtube.com/watch?v=X2_ksaDtYQw (DSM-4 criteria… since revised a bit in DSM-5)

2. https://www.youtube.com/watch?v=P-wtNEp8E6Y (DSM-5)

 

 

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Interventions

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As with the other anxiety disorders, early and intensive provision of emotional support services is mandatory.  Support from parents, school, and peers is essential.  These supporters will most likely need to be trained so that they can be truly therapeutic in their assistance, and avoid inadvertantly heightening the after-effects of the trauma.Most importantly, the supporters of this youngster must work as a team to establish feelings of being safe and protected in the aftermath of happenings that have created doubt of that safety and security. Therapy sessions by well-trained individuals should allow the youngster to play, draw, write or talk freely about the event.  Reflective listening strategies help the youngster to continue addressing the emotional challenge in a supportive environment.&nbs p;
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How we phrase things when talking with anxiety-impacted kids can heighten or lower the perception of a threat.
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Other sometimes-indicated interventions include behavior modification techniques that promote “desensitization” (engaging in progressive goals that reduce the frequency and intensity of the negative recollections), and cognitive behavioral therapy that teaches the child to reframe the events in a manner that helps to reduce fears and worries.
 
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Medication can also contribute to a lessening of anxiety, and ability to benefit from counseling as the youngster deals with the emotional after-effects of the trauma.  Some of the common prescription meds are: SSRIs (selective serotonin reuptake inhibitors that stop recycling thoughts), antidepressants, and Bensodiazepines (anti-anxiety/sedatives).Bibliotherapy and play therapy are often utilized.

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How to talk with kids in a manner that reduces anxiety & builds positive relationships

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Freebie for you and your kids with anxiety: Knowing that her teachers needed to decompress after their work day, Dr. Donia Fahim (“Dr. Donia”), a former colleague of mine in our Department of Special Education at Hunter College would start and end her evening graduate classes with a short relaxation session.  I asked her to make an audio recording for me.  She was kind to do so.  To listen to this free 11 minute audio,  here’s the link https://youtu.be/2Mbg9BXNweQ.  Call it up, close your eyes, and fl oat away.

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Remember that you can find all of the previous weeks’ blasts (Murphy’s Law as applied to behaviour, ODD, ADHD, Generalized Anxiety Disorder, various other Anxiety Disorders) at: http://www.behavioradvisor.com/blog-3/   Scroll down through them to find the one you’d like to read. 

 

** Be aware that I conduct workshops for schools and the general public regarding Childhood Trauma, it’s effects on youngsters (physically, cognitively, emotionally) and how the schools and community can respond.  If your district is interested, contact me at DoctorMac@BehaviorAdvisor.com

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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.

Liking these weekly B-List Blasts?

Buy Dr. Mac a Cup of Coffee! Dr Mac - CupOfCoffee (Click on the cup for info) (or go to paypal at Doctormac@BehaviorAdvisor.com to say “Thanks“.)

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Sep 082018
 

We have nothing to fear, but fear itself!

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Certainly the inspirational phrase from Franklin Delano Roosevelt was intended for a different reason (to comfort and inspire the homefront during WWII), but it seems somewhat appropriate for this week’s write-up and video.  This week we’ll become informed regarding GAD (eGADs & GADzooks!); Generalized Anxiety Disorder.  It’s the first in a series on the anxiety disorders that include the five major types (as per the U.S. Department of Health and Human Services, quoted here):

Generalized Anxiety Disorder

  • Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing to provoke it.
  • Obsessive-Compulsive Disorder (OCD)
    Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called “rituals,” however, provides only temporary relief, and not performing them markedly increases anxiety.
  • Panic Disorder
    Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
  • Post-Traumatic Stress Disorder (PTSD)
    Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.
  • Social Phobia (or Social Anxiety Disorder)
    Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation – such as a fear of speaking in formal or informal situations, or eating or drinking in front of others – or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.”

We’ll also look at other anxiety disorders such as “Selective Mutism” and other phobias (specific fears).

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Now don’t get nervous!  We’ll take it slow and guide you gently this week.

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Let’s start at the beginning (Yes, I too remember Mary Poppins singing this sentence).  Let’s look first at that general anxiety category.

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Anxiety in Our Lives

We all experience nervousness and concern about life events.  Anxiety is a normal and expected emotion in humans all over our blue-green orb.  We often feel tense before taking a test, and worry about problems at work or home.  Important impending decisions make us bite our lips and nails.

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However, anxiety disorders move beyond everyday stress to longterm distress that interferes significantly with a person’s ability to lead a normal life.  Its causation is more complicated than being of “weak” constitution.  Overcoming it requires more than simply “toughing it out” and “sucking it up”.  An anxiety disorder is a serious mental illness that is socially and emotionally overwhelming… Indeed, it is psychologically crippling.  For people who struggle with anxiety disorders, extreme worry and fear are constant companions.

 

 

As with adults, anxiety in children and youth is a normal part of childhood.  Every child goes through phases… crying as an infant or toddler when separated from the caretaker, fear of the boogie man and other assorted monsters in the closet or under the bed, nervousness about one’s performance before “the big game”, and sweating over the entrance exam for that prestigious high school.  However, these events and phases are temporary and usually emotionally harmless.  Youngsters who suffer from an anxiety disorder experience incapacitating fear, nervousness, and shyness on a persistent long-term basis.  Due to it, they avoid certain places and activities.

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When Nervousness is Magnified

It is estimated that about 1 in 8 children possess an anxiety disorder. Left untreated, this condition places children at high risk for missing out on important social experiences, performing poorly in school, and engaging in alcohol and/or drug abuse to numb the fears and concerns.  With treatment and support, these youngsters can successfully manage the symptoms and engage in normal childhood activities and pursuits.

 

Anxiety is often “co-morbid” (Yeah, I don’t like that term either… it means “can occur at the same time”) with other disorders such as ADHD, depression, and eating disorders.  Given their insecurities, concerns about being judged by others, and striving for perfection, our anxious youngsters may persistently seek reassurance and approval from others.  Children with anxiety disorders are often quite hard and critical on themselves, psychologically self-flagellating for not being “normal” … beating themselves up, emotionally speaking.

 

Whereas, generalized anxiety disorder (GAD) reveals a pattern of overly strong and constant worry and negative stress pertaining to a wide variety of different events and issues, other variations are more finely tuned.

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So… WHAT IS GENERALIZED ANXIETY DISORDER?

Everyone gets anxious and concerned, but it the frequency, duration and intensity of that fearfulness of what might transpire that takes a common human condition and turns it into to a disability

Here are the identifiers:

  • Persistent, exaggerated, excessive unrealistic worrying about everyday things with no obvious reason for doing so.
  • Multiple non-specific worries.  Worries about multiple possible happening/negative outcomes.  Difficulty focusing on one concern without bringing others to mind.

It is the most common anxiety disorder (and perhaps the most common mental health condition).

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DSM-5 Diagnostic Criteria (paraphrased)

Must occur for at least 6 months and occur more days than not.

The child/youth finds it difficult to manage the worry.

The child/youth displays one of the following: restlessnes or a feeling of being “one edge”, becoming easily fatiqued, having difficulty concentrating, irritability, muscle tension, or sleep disturbance. (Adults must show 3 symptoms.)

The disturbance is not due to medications, a medical condition, or another mental health disorder.

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Here’s the GAD video, courtesy of one of the revered grad students in my teacher training program in the area of mental health an behavior disorders.  It describes a youngster before comparing his characteristics with the diagnostic criteria for GAD.  Strategies are presented at the end. – https://www.youtube.com/watch?v=g_lZvBtpkys

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Interventions

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Early and intensive provision of emotional support services is mandatory.  Support from parents, school, and peers is essential.  These supporters will most likely need to be trained so that they can be truly therapeutic in their assistance, and avoid inadvertantly heightening the after-effects of the trauma.Most importantly, the supporters of this youngster must work as a team to establish feelings of being safe and protected in the aftermath of happenings that have created doubt of that safety and security. Therapy sessions by well-trained individuals should allow the youngster to play, draw, write or talk freely about the event.  Reflective listening strategies help the youngster to continue addressing the emotional challenge in a supportive environment. 

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Other sometimes-indicated interventions include behavior modification techniques that promote “desensitization” (engaging in progressive goals that reduce the frequency and intensity of the negative recollections), and cognitive behavioral therapy that teaches the child to reframe the events in a manner that helps to reduce fears and worries.
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Medication can also contribute to a lessening of anxiety, and ability to benefit from counseling as the youngster deals with the emotional after-effects of the trauma.  Some of the common prescription meds are: SSRIs (selective serotonin reuptake inhibitors that stop recycling thoughts), antidepressants, and Bensodiazepines (anti-anxiety/sedatives).Bibliotherapy and play therapy are often utilized.

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During and after the school day, teachers also need to find mental calm; whatever gives one inner peace and strength.  There are many ways to do so; listen to music, exercise, engage in a hobby, spend time with special people, visit the dispensing machine in the teachers’ lounge…

It’s important to ensure that one does not seek calm with too much of this method.

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To assist with that goal, Dr. Donia Fahim, a former colleague of mine in our Department of Special Education at Hunter College, created an audio relaxation tape.

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Knowing that her teachers needed to decompress after their work day, “Dr. Donia”, a former colleague of mine in our Department of Special Education at Hunter College would start and end her evening graduate classes with a short relaxation session.  I asked her to make an audio recording for me.  She was kind to do so.  To listen to this free 11 minute audio,  CLICK HERE Click for more options or here ( https://youtu.be/2Mbg9BXNweQ ).  Call it up, close your eyes, and float away..

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

Buy Dr. Mac a Cup of Coffee! Dr Mac - CupOfCoffee (Click on the cup for info) (or go to paypal to say “Thanks”.)

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Sep 082018
 

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But that’s just my free-floating general anxiety in life. 

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HELLO FELLOW B-LISTERS!!  This week, as we continue with our write-ups and (free) videos regarding DSM-5 diagnoses that are found in the records of our students labeled “emotionally disturbed” (Oh, how I hate that term… How about “emotionally challenged” or “emotionally readjusting”?) or “other health impaired” (U.S. terms).  Given the 3-day weekend in the U.S. (celebrating our labor force), let’s give you the remainder of the anxiety videos.  If you’re reading this B-List blast from out side the states, you’ll have to cram it all in during your shorter weekend.

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Before you binge watch these videos related to anxiety disorders, do be aware that you can find the previous weeks’ blasts (Murphy’s Law as applied to behaviour, ODD, ADHD, and Generalized Anxiety Disorder) at: http://www.behavioradvisor.com/blog-3/   You’ll need to scroll down through the listing to find the one you’d like to read. (My tech help went off to college, so we’re stuck with this set-up until I find another teen tech wiz.)

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OVERVIEW: All anxiety disorders have the same derivation: An irrational (to others) fear of something; a perception of a threat to their physical or psychological comfort/safety.

This week, I’ll let the videos do the talking. (Too late?)  Each will provide you with the case study of a hypothetical youngster.  Then the characteristics of that learner will be compared to the diagnostic criteria of the DSM-5 diagnostic manual structure for that disorder.  That part is then followed by suggestions for intervention.

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These videos (made by my wonderful graduate students in my teacher training program in the area of mental health and behavior disabilities) would serve well for short staff professional development sessions.  Professors could make use of them in classes.  Parents of children/youth with these conditions would become more informed.  Spread the informational  wealth!

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So, without further ado, this week’s videos can be found at the following links:

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Agoraphobia (with panic attacks) – (2 parts based on the criteria of DSM-IVtr, an  earlier version of DSM)

                Part 1 – https://www.youtube.com/watch?v=FphWF2yTX3E

                Part 2 – https://www.youtube.com/watch?v=dDZVuz8aAGA

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Generalized Anxiety Disorder (last week’s video) – https://www.youtube.com/watch?v=g_lZvBtpkys

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Obsessive Compulsive Disorder (OCD) – https://www.youtube.com/watch?v=J1Uia0UOGkE

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Selective Mutism – https://www.youtube.com/watch?v=A29zj0LdauM

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Separation Anxiety – https://www.youtube.com/watch?v=ldJ7ocs0gE0

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Social Anxiety Disorder (SAD) – https://www.youtube.com/watch?v=cwEh0rh94XQ

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Social Phobia (the Social Anxiety Disorder diagnosis when it had a different name & slightly different criteria under the previous DSM manual)

                Part 1 – https://www.youtube.com/watch?v=zHiEKwGNoVI

                Part 2 –  https://www.youtube.com/watch?v=rdmjXMuJnSM

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PTSD (Post Tramatic Stress Disorder in children) – Let’s save this one for next week’s mailing. 

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Interventions

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Early and intensive provision of emotional support services is mandatory.  Support from parents, school, and peers is essential.  These supporters will most likely need to be trained so that they can be truly therapeutic in their assistance, and avoid inadvertantly heightening the after-effects of the trauma.Most importantly, the supporters of this youngster must work as a team to establish feelings of being safe and protected in the aftermath of happenings that have created doubt of that safety and security. Therapy sessions by well-trained individuals should allow the youngster to play, draw, write or talk freely about the event.  Reflective listening strategies help the youngster to continue addressing the emotional challenge in a supportive environment. 
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How we phrase things when talking with anxiety-impacted kids can heighten or lower the perception of a threat.
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When the tides of life turn against you… And the waves upset your boat… 
Don’t think of the way things might have been… Just lay on your back and float!
Art Carney (famous comedic actor talking to Jackie Gleason on the old “Honeymooners” TV show)

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Other sometimes-indicated interventions include behavior modification techniques that promote “desensitization” (engaging in progressive goals that reduce the frequency and intensity of the negative recollections), and cognitive behavioral therapy that teaches the child to reframe the events in a manner that helps to reduce fears and worries.
 
 
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Medication can also contribute to a lessening of anxiety, and ability to benefit from counseling as the youngster deals with the emotional after-effects of the trauma.  Some of the common prescription meds are: SSRIs (selective serotonin reuptake inhibitors that stop recycling thoughts), antidepressants, and Bensodiazepines (anti-anxiety/sedatives).Bibliotherapy and play therapy are often utilized.

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How to talk with kids in a manner that reduces anxiety & builds positive relationships

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Freebie for you and your kids with anxiety: Knowing that her teachers needed to decompress after their work day, Dr. Donia Fahim (“Dr. Donia”), a former colleague of mine in our Department of Special Education at Hunter College would start and end her evening graduate classes with a short relaxation session.  I asked her to make an audio recording for me.  She was kind to do so.  To listen to this free 11 minute audio,  here’s the link https://youtu.be/2Mbg9BXNweQ.  Call it up, close your eyes, and fl oat away.

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 GLOSSARY

  • Generalized Anxiety Disorder, GAD, is an anxiety disorder characterized by chronic anxiety, exaggerated worry and tension, even when there is little or nothing apparent to provoke it.
  • Obsessive-Compulsive Disorder (OCD)
    Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as hand washing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called “rituals,” however, provides only temporary relief, and not performing them markedly increases anxiety.
  • Panic Disorder
    Panic disorder is an anxiety disorder and is characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, dizziness, or abdominal distress.
  • Post-Traumatic Stress Disorder (PTSD)
    Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.
  • Social Phobia (or Social Anxiety Disorder)
    Social Phobia, or Social Anxiety Disorder, is an anxiety disorder characterized by overwhelming anxiety and excessive self-consciousness in everyday social situations. Social phobia can be limited to only one type of situation – such as a fear of speaking in formal or informal situations, or eating or drinking in front of others – or, in its most severe form, may be so broad that a person experiences symptoms almost anytime they are around other people.”

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in Behavior Disorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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  Liking these weekly B-List Blasts? 

Buy Dr. Mac a Cup of Coffee! Dr Mac - CupOfCoffee (Click on the cup for info) (or go to paypal at Doctormac@BehaviorAdvisor.com to say “Thanks“.)

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Aug 182018
 

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Huh?  What?  OH! 

Hello fellow B-Listers!  It’s time for another video regarding a particular mental health disorder.  About once a week, you’ll receive information and a case study video to your e-mail inbox that will increase your knowledge and skill bases in working with kids with mental health and behavior challenges.

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Last week’s topic, ODD received the most votes and became our first video in the series.  (I chuckle at the ODD acronym, although I never did so when the behaviors that comprise it were demonstrated in my classroom.)  You can re-visit that video and write-up at: http://www.behavioradvisor.com/oppositional-defiant-disorder-odd-info-video/

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ADHD came in as runner-up to ODD, making it the topic for this week’s blast.  Next week?  We’ll start a slew of videos and information on anxiety-based disorders; the most common mental health concerns in kids and adults.

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Oops… please excuse my distracted attention to the issue at hand.  Here’s the write-up and video on ADHD. 

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Neurological causation? Lack of structured parenting?  Merely the most evident symptoms of a more serious mental health disorder?  Why are kids from poverty more likely to be identified? Do the medications that subdue the symptoms place the youngster at risk for stunted growth or future illicit drug use?  Certainly ADHD is receiving a great deal of attention (pun intended), especially with the newly published medical and pharmaceutical research (e.g., brain scans, medication trials, etc.) leading the way.  Herein, you’ll find the basic information on the condition(s), a nice case study video by one of my grad students, and suggestions for interventions. 

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General Overview

  • 6% of American kids have been diagnosed.  That is a 50% increase in diagnosis from 2010 to 2018.
  • ADHD impacts children of all races, but certain conditions might impact the various races/cultures in different ways. From 2001 to 2010, the rate of ADHD among non-Hispanic black girls increased over 90 percent.
  • ADHD affects children of all races, but here is a break down of diagnosed youngsters:
    • Whites: 9.8%
    • Blacks: 9.5%
    • Latinos: 5.5%
  • Symptoms of ADHD typically first appear between the ages of 3 and 6.
  • The average age of the initial ADHD diagnosis is 7.  However, the severity of the symptoms impacts the age of diagnosis.
    • 8 years old: average age of diagnosis for children with mild ADHD
    • 7 years old: average age of diagnosis for children with moderate ADHD
    • 5 years old: average age of diagnosis for children with severe ADHD
  • ADHD isn’t just a childhood disorder. About 4 percent of American adults over the age of 18 deal with ADHD on a daily basis.
    • 13 percent of men will be diagnosed with ADHD during their lives. In comparison
    • 4.2 percent of women will be diagnosed.

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More statistics regarding ADHD can be found at  https://www.healthline.com/health/adhd/facts-statistics-infographic#demographics

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When DSM-5 was published, ADHD moved from being deemed a disruptive disorder to the category ofneurological disorders.  Certainly it is both.  Remember please that kids a result of, a product of, and sometimes a victim of their life circumstances.  No child of a mother in labor thinks “I can’t wait to get out there to cause havoc!” (At least my mind-reading skills tell me that as-of-yet unstudied time period previous to birth.)

 ADHD is a neurological disorder, so don’t hate the victim.  Work to support these youngsters in their struggle to change their behavio(u)r for the better.

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 Image copied from https://hariomhomoeo.com/adhd-medications-1/

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The DSM-5 Criteria for Diagnosis

 (Source: American Psychiatric Association (2013). DSM-5, Washington, D.C.: American Psychiatric Association)

The individual must meet the criteria for Inattention, Hyperactivity/Impulsivity, or Both

1. Inattention 17 & younger: Six or more of these symptoms must be present for at least 6 months, be inconsistent with the child’s developmental level, and have a negative effect on their social and academic activities. To be endorsed, the following must occur “often”:

a. Fails to pay close attention to details

b. Has trouble sustaining attention

c. Doesn’t seem to listen when spoken to directly

d. Fails to follow through on instructions and fails to finish schoolwork or chores

e. Has trouble getting organized

f. Avoids or dislikes doing things that require sustained focus/thinking

g. Loses things frequently

h. Easily distracted by other things

i. Forgets things

2. Hyperactivity and Impulsivity Six or more of these symptoms must be present for at least 6 months, be inconsistent with the child’s developmental level, and have a negative effect on their social and academic activities. To be endorsed, the following must occur “often”:

a. Fidgets with hands/feet or squirms in chair

b. Frequently leaves chair when seating is expected

c. Runs or climbs excessively

d. Trouble playing/engaging in activities quietly

e. Acts “on the go” and as if “driven by a motor”

f. Talks excessively

g. Blurts out answers before questions are completed

h. Trouble waiting or taking turns

i. Interrupts or intrudes on what others are doing

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3 TYPES

  • ADHD Predominantly Inattentive Presentation (ADHD-PI)
  • ADHD Predominantly Hyperactive-Impulsive Presentation (ADHD-PHI)
  • ADHD Combined Presentation (Inattentive & Hyperactive-Impulsive) (ADHD-C)

The condition can be:

Mild: Six or only slightly more symptoms are present and impairment in social or school functioning is minor

Moderate: Symptoms or impairment is between mild and severe

Severe: (Many symptoms above the required 6 characteristics are present and/or symptoms are severe; impairment in social or school functioning is severe)

Source: Stepping Stones Psychological Services of Princeton, LLC with minor wording modifications

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Free! 40 strategies for working effectively with kids with ADHD

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 Image copied from https://hariomhomoeo.com/adhd-medications-1/

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HERE’S THE VIDEO developed by Andrea, one of the wonderful grad students in my teacher training program in mental health & behavior disorders.

 https://www.youtube.com/watch?v=921hNTi6a98

(13 minutes)

 

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Other Resources  

  1. Dr. Mac’s web page – http://www.behavioradvisor.com/AddOverview.html
  2. Video on ADHD using DSM-IVtr criteria (the criteria before DSM-5 was published) – https://youtu.be/0Wz7LdLFJVM      The difference between the two editions is this: Diagnosis of ADHD now requires a minimum of six symptoms of inattention and/or 6 symptoms of hyperactivity/impulsivity for children.  In DSM-5, some of the symptoms must have been present by age 12.
  3. ADHD and ODD/CONDUCT DISORDER overlap – http://www.chadd.org/Understanding-ADHD/About-ADHD/Coexisting-Conditions/Disruptive-Behavior-Disorders.aspx
  4. ADHD medications – https://childmind.org/article/understanding-adhd-medications/?utm_source=newsletter&utm_medium=email&utm_content=ADHD%20Medications&utm_campaign=Weekly-7-31-18

 

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Looking for effective strategies for youngsters with ADHD?

You’ve found them!

 The ultimate what-to-do and how-to-do-it listing:

240 strategies for reaching & teaching (and parenting) kids with ADHD!

  http://www.behavioradvisor.com/AddStrats.html

 

 

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in BehaviorDisorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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Dr. Mac
Room 914west, 
Department of Special Education, Hunter College, 
695 Park Avenue, 
New York, 
NY 10021
Doctormac@BehaviorAdvisor.com

Aug 182018
 

This post was sent to the BehaviorAdvisor.com “B-List” in August of 2018.

To sign up for these e-mail blasts, go to http://www.behavioradvisor.com/intervention-strategies/

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Hello again, fellow B-Listers!  As promised, here is the humor.  Let me preface the ditties with a bit of professional caution:

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When professionals of any line of work perform in high-pressure environments, they develop forms of idiosyncratic humor.  Using hyperbole and overstatement, these situational comedic remarks become common-place, turning into reactive mantras chanted when recurrent situations arise.  These repartee help to lighten difficult times and promote comradery among those specialized groups of professionals.

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Please consider these statements in the tone intended; to help us laugh so that we don’t cry… to relieve stress and express empathetic collegiality.  Humor is dependent on exaggeration and surprise; reality hyperbolized.  The “observations” found below make full use of embellishment and magnification of rare or occasional events.

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Hopefully, the outcome is that we have a bit of fun here with no disparagement intended at all. These verbal responses to head shaking events are phrased in the style of “Murphy’s Law”.  Murphy’s Law states that:  “Anything that can go wrong, will go wronç.”

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P.S. “Discipline”, as used in this document, refers to interventions designed to teach new and more appropriate behavioral responses, not simply to punish the offender.  (The latter approach is a good example of how Murphy’s Law has affected good practice.)

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Murphy’s Law As It Applies to Behavior Management

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Books Regarding Classroom Behavior Management

 1. The first myth of “quick and easy” discipline is that it actually exists. (Quick and easy discipline isn’t.)

2.  Any behavior management book offering “sure-fire” or “quick-fix” strategies should be filed under “fiction”.

3.  While reading about “Research-based Practices” and “Applied Behavior Analysis”, the reader will be unable to shake mental images of white rats using palate & brush (made from push bars at the end of mazes) to create a paint-by-numbers portrait of B.F. Skinner.

4.  Any publication purporting a “new” management strategy or discipline approach has simply renamed an old one.  The 1970s originator of the initial strategy will be given no credit by the authors of the “new” idea.

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Professional Development

5.  When the professional development presenter mentions the “Fight, flight or freeze response”, you will think of a fourth one displayed by your students; “Freak out!”

6.  Given the honor of presenting the keynote address at the district conference, the powerpoint slide show that you spent weeks preparing will crash immediately after the title slide.

7.  If it doesn’t crash, you will smoothly and confidently present your memorized session, nonchalantly clicking the remote to change slides while you personally engage with the audience.  Pleased with yourself, you’ll make the assumption that the wide eyes and open mouths are due to their full-focus attention.  Later, at the disciplinary hearing, you will explain to the district superintendent and school board at the disciplinary hearing that you were unaware of the pornographic images and various Dr. Seuss characters that were inserted the day before by your students while you searched in the hallways for your eloper.

8.  After the presentation you will notice that your blouse had two buttons undone or your zipper was down.

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Assessment and Diagnosis

9.  A “Functional Behavior Assessment” is a complex systematic procedure for arriving at the wrong conclusion with great confidence.  The process should, instead, be known as “Dysfunctional Behavior Assessment”

10.  Determining the function of some behaviors is like trying to smell the fifth color of the alphabet.

11.  On the day when the School-Based Support Team finally arrives to your classroom to observe an offending student, she’ll be angelic, on-task, and answering every question correctly.

12.  Despite every item on a checklist of inappropriate behaviors being marked with the highest scores, and the student’s total score falling into the 99th percentile of aberrant behavior, the results will not meet the district’s cut-off score for obtaining special services.

13.  When presenting the results of the psychological assessment, the evaluator who just came from a three martini lunch will utter a diagnosis of “Bonkers”.

14. Despite impressive increases in the test scores of the kids in your self-contained classroom, the merit pay raise will go to the teacher of the gifted class.

15. Upon reading the psychologist’s report on his administration of various projective tests (e.g., Rorschach Inkblot, incomplete sentences, Children’s Apperception Test, Educational Apperception Test), you will realize that you now know much more about his mental state than that of your student.

16. Upon reading the psychologist’s report, you will ponder whether to complete a referral form on him or call the police.

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Our Students

17.  Your worst behaved student will have a perfect attendance record.

18.  Any positive prosocial behavior you have instilled in a “difficult” student will disappear over the holiday break.

19.  When a student states that s/he comes from “the street”, it ain’t Sesame Street.

20.  Your soon-to-arrive new student will be likened to “behavioral popcorn”: You know he’s going to explode; you just don’t know when.

21.  Upon a recurrence of that irritating behavior, you will find yourself thinking of a variation on the words of the great American patriot, Patrick Henry; “I regret that I have but one life to give for my country, but let’s make it A.J. in the 3rd row.”

22.  Despite making use of extensive roleplaying during your social skills lessons, the student will forget to wipe the booger off his finger before shaking hands with the district superintendent.

23.  If it’s true that “You are what you eat”, you have 3 kids in the front row who are boogers.

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Sending A Student To The Office

24a.  Any student sent to the office for discipline will immediately display worse behavior upon return to the classroom.

24b.  Any student sent to the office for discipline will be treated like a visiting dignitary by the office staff.  He will then be filled with cookies and other baked goods before being asked to run off photocopies.

24c.  While unsupervised at the copy machine, that student will photocopy his buttocks.

24d.  Later in the day, a photocopy of a d’arrière, turned sideways, will be found on the teacher’s desk.  Across the image, now sporting inked eyes and nose on the upper cheek, will be scrawled the caption: “Mr. McMeanie’s big smile.”

24e.  When Mr. McMeanie asks the class who placed the buttocksian image on the his desk, all fingers will point to the gifted kid with Aspergers.

24f.  When the head of the disciplinary meeting mentions the gifted student’s Aspergers Syndrome, the parents will overhear Mr. McMeanie whisper “Yeah…pain in the Assperger’s Syndrome”.

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Administrators

25.  Convincing an authoritarian administrator to consider positive practices will be akin to trying to ski through a revolving door.  You can see your goal, but it ain’t gonna be easy getting there.

26a.  Any behavior management procedure that was here-to-fore unknown to the administrator will be poo-pooed when you suggest it.  Any interventions he suggests will worsen the situation.

26b.  If the administrator’s suggested intervention works, something went wrong.

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The Administrator’s Lesson Observation

27.  While your fidelity to the DRL program has reduced the utterance of the “F word” from 103 to 6 times per week, all 6 times will occur during the administrator’s visit.

28.  When hearing the snickers and seeing your students point at the board, you will turn around to see that in your haste to write “Pencils only. Use of a pen is not allowed”, you forgot to place a space between “pen” and “is”.

29.  If the lesson goes well, your class size will be increased. (No good act goes unpunished.)

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Fellow Teachers

30a.  Any progress you have made in motivating an errant youngster to make better behavior choices will be destroyed by the teacher she sees next. (Sisyphus will someday be adopted as the patron saint of teachers who work with kids who possess mental health and behavioral challenges.)

30b.  The teacher she sees next will vehemently defend his practices as being necessary to “teach her a lesson”.  (“Teaching ‘em a lesson” doesn’t.)

30c.  If the administrator treats that mean teacher like he treated the student, the teacher will file a union grievance.

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31a.  Given the level of flatulence emanating from Henry, the gen. ed. science teacher will suggest to the IEP team that he be labeled a level 3 biohazard.

31b.  The team will change Henry’s label from “disorder” to “disodor”.

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32a.  When substitute teaching in a general education class during your planning period, you’ll discover that you actually possess incredible teaching and management skills. That master teacher that you replaced will gladly return the favor by “covering” your self-contained classroom while you attend an IEP meeting.  He will fail miserably.

32b.  Upon returning to your classroom after the IEP meeting, you will find the gen. ed. master teacher locked in the teacher’s closet.

32c.  Your students will be released from in-school suspension after the investigation reveals that the master teacher locked the closet door from the inside.

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33.  When informed that your student with O.D.D. is being mainstreamed into his gen.ed classroom, the teacher’s face will resemble that of someone who just ate a bad clam.

34.  Given extensive, expensive and intensive professional development in research-proven effective practices, and implementation of expansive supports to maintain fidelity to the new interventions, tenured teachers will do as they damn well please.

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Part 2 arrives tomorrow!  Stay tuned.  If your friends and colleagues want to join us, they can sign up for our B-List at http://www.behavioradvisor.com/intervention-strategies/

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Dr. Mac

DoctorMac@BehaviorAdvisor.com

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Differential Reinforcement: It’s a $20 term for a $1 idea, but they are a POWERFUL set of behavior change procedures.  When “Nothing works with this kid”, DR does.  Check it out at http://www.behavioradvisor.com/Teacher-SchoolServices/DifferentialReinforcement.html

 

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Aug 172018
 

This post was sent to the BehaviorAdvisor.com “B-List” in August of 2018.

To sign up for these e-mail blasts, go to http://www.behavioradvisor.com/intervention-strategies/

 

 

Hello fellow B-Listers! (Yes, I know that our group name looks like “blisters”.  It’s Murphy’s Law in action.)

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Here is the 2nd half of my musings on that universal fact-of-life as it applies to behavio(u)r in the schools.

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One last caution: Please take the remarks as intended; to add some levity to our day, but NOT at the expense of the dignity of others.  Remember to share these hyperbolized observations with this caution.  A kid’s sense of self is fragile.  Handle with care.

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Items 1-35 were sent in yesterday’s e-mail blast.

Discipline Plans

35.  The degree of effectiveness of a disciplinary intervention is inversely proportional to the level of management that devised it.

36. Discipline plans are typically devised by committees of individuals with poor behavior management skills.

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37a.  If the teaching staff has developed a thoughtful, positive, and effective school-wide discipline plan, getting district approval will be like mating elephants:

             -It’s done at a very high level

             -It involves a great deal of bellowing and screaming

             -And it takes two years to get results…

                                          (And sometimes you’re crushed by those results.)

37b.  If the plan is approved and placed into practice, the teacher who would most benefit from complying with it will file a union grievance.

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38.  Despite implementation of expensive and complex comprehensive systems for teaching peer mediation, conflict resolution, and anger management, the best method for resolving disputes will still be ‘Rock, Paper, Scissors’.

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39a.  When Cosmo is soon returning to the sending school from a residential setting for youth with behavioral challenges, the district lawyer will inform the IEP team that deportation and lethal injections are not suitable consequences for the Behavior Intervention Plan.

39b.  After further discussion, the lawyer will also determine that giving wedgies is verboten.

39c.  Additionally, despite the urging of certain faculty members, it will be determined that a strait jacket cannot be considered a “wrap-around service”.

39d.  When the parent states that Cosmo “doesn’t have a mean bone in his body.”, a former teacher of the student will grumble “Yeah.  Neither do sharks.”

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Support Personnel & Others

40.  The main function of bus drivers is to agitate explosive students before they get to school.

41.  Any student progress promoted by a positive and effective teacher will be fully neutralized by a negative-natured paraprofessional with 30 years’ experience who refuses to be transferred to another classroom.

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42a.  In an attempt to appear knowledgeable, the consultant will explain even the simplest of interventions in a complicated manner.

42b.  If the consultant’s intervention works, you failed to follow the steps as directed.

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43.  Despite advanced training, school psychologists don’t know one millionth of 1% about anything related to abnormal psychology or aberrant behavior.  However, that is 100 times more than the rest of us know.

44.  The main function of the IEP Team is to make things difficult for the administration and impossible for the teacher.

45.  Your paraprofessional will inadvertently sabotage your intervention plan when he mistakenly assumes that “negative reinforcement” means that he should reward bad behavior.

46.  The counselor, in an attempt to promote “theory of mind” in his small group of conduct disordered youth, will begin with the only empathic connection to other’s pain in others that they possess at that moment in time; showing slow-motion video clips of soccer players and movie characters getting kicked in the groin. 

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Miscellaneous 

47.  As is your habit, you reach into your lunch bag and pull the tab on your soda can before lifting it out.  You follow the line of your colleague’s perplexed stare to said container, suddenly realizing that during your sleepy early-morning preparation, you packed a beer.

48.  Pleased with your class’ quick and quiet exit during a fire drill, you will later have to explain to the district superintendent why you took the students outside when the alarm sounded for the tornado drill.

49.  Upon handing back student homework, your mistakenly pasted upside-down “WOW” sticker will be interpreted as a mother insult.

50.  When your most troublesome student is finally assigned to a more appropriate setting, the behavior of the youngster who replaces him will be 10 times worse.

51.  Upset at their child’s “ghost services” (services written into the IEP, but never actually delivered to the pupil), you will jokingly suggest to the parents that they show up to the IEP dispute meeting in jump suit and backpack vacuum cleaners (ala “Ghost Busters” costumes).  The costumed parents show up late to the meeting with the older sibling recording to facebook live.  The wide-eyed district administration then guarantees the twice-a-week counseling sessions on the soon-to-be viral video.  Your cupped hand hides your grin, but your eyes show it as the parents look thankfully your way.  You will arrive to your classroom the next day to see the Ghost Buster’s logo pasted to your classroom door.

52.  Noticing that the errant and confrontational student you’re sending to the Dean of Discipline is packed up and carrying an arm-load of items toward the door, you will ask the him “Where should I place this office discipline referral form?”  He will respond with “Stick it where the sun don’t shine.”  With a smirk on your face, you will stuff it into the back of his pants.  Touche’!

53.  When we punish kids “for their own good”, it is the disciplinary equivalent of administering Robitussin cough syrup; we tell them it’s good for them, but it leaves a nasty taste in their mouths.

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Summation

51.  All great interventions were discovered by mistake.

52.  Advanced skill in behavior management is indistinguishable from magic.

53.  The key to effective discipline is to work smarder, not harder.

54.  Some days we wonder if it’s worth the effort to chew through the emotional restraints and jump the psychological wall to get to school.  Thankfully, most days it is so.

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Endnote

Individuals who effectively serve kids with emotional and behavioral disorders perform thoughtful and skilled actions that others cannot comprehend, wouldn’t know how to attempt, and could not accomplish.  You are part of a select group of educational professionals who step forward when others step back.  To quote an old military recruitment slogan, you are “The few. The proud, the”…  mentors of kids with mental health and behavior challenges.

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Folks like you possess the rare ability to envision promise and progress in youngsters that others have discarded.  I am reminded of a television show; History Channel’s program titled “American Pickers”.  These antique dealers go around the country stopping at the homes, barns, and storage sheds of collectors of old items.  Those individuals who reclaim these pieces are able to see value in things that others have thrown on the trash heap.

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It takes even more observational astuteness to recognize underlying worth at the human level, and strive to restore that rejected kid to value.  You are among the few who are able to imagine the personal shine that would be evident if we rub off the emotional tarnish, make necessary psychological repairs, and then admire a somewhat flawed piece for its distinctiveness and inherent beauty.

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If I may add a corollary to Murphy’s Law; “Anything that can go wrong might possibly go wrong, but thank goodness you’ll be there to make it better than it might otherwise be.” 

Here’s the 1st item on that list: Kids who experienced failure with others will find hope in you. Their hope will be fulfilled.

Here’s the 2nd one: At the end of the school day, you earth angels will realize that your reward may not come to you here on this granite planet, but you have earned a few more points toward heaven by the time you leave this blue-green orb.

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You make a difference in the lives of unfortunate kids.  Thank you.

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Do you teach students who exhibit resistance and defiance… failing to follow your routines and directions?  The way that we phrase our utterances, can reduce the “heat” or light the fuse to the emotional power keg.  Bring forth cooperation by phrasing your directions, praise, and commentary in ways that enhance the chances of compliance.  Check out this video series at http://behavioradvisor.com/Webinar.html

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Dr. Mac

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Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in BehaviorDisorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

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Dr. Mac

Room 914west, 
Department of Special Education, Hunter College, 
695 Park Avenue, 
New York, 
NY 10021
Doctormac@BehaviorAdvisor.com

 

 Posted by at 7:38 pm
Aug 172018
 

This e-mail blast was sent to members of the BehaviorAdvisor.com “B-list” on 8/11/18.

Sign up at http://www.behavioradvisor.com/intervention-strategies/

 Hello again fellow B-Listers!

.

Remember that request to let me know if you have a favored mental health topic for our upcoming series of videos?

 Well, knock me over with a feather duster… Actually, I suspected that it would be the case given my conversations with educators; Oppositional Defiant Disorder was nominated most often to be our first video in the series on mental health and behavior disorders.

.

 ADHD came in second.  Expect to see that video in about a week or so.

.

So… Let’s get started with our video series, and I’ll be certain to eliminate words like the one that sounds exactly like the name for a wall that holds back water.  Many folks who use their organization e-mail addresses found the e-mail being rejected when profanity filters spotted that word.  Dam_!  I didn’t know that it ranked so high on the curse word scale.

.

The video link is found near the end of this write-up.

.

Now I may not be Lamont Cranston (Google it), but I do know what’s on your mind.  You interact with kids who, it often seems, possess life missions to oppose what we propose, and forward objection to our direction. (I can rhyme all the time; I’m a poet and I know it.)  Certainly, all kids (and adults) can be oppositional from time-to-time, particularly when they (we) are tired, stressed-out, hungry, or frustrated. Refusals and back-talk then become the order of the day.  We might expect a certain degree of obstinence from two or three year olds and younger adolescents.  However, public resistance and hostility becomes a must-be-addressed concern when it happens so often an d persistently that it’s undoubtedly two standard deviations from the average for age and developmental level.

.

Call it what you will;  there are many names for it in the Thesaurus (my favorite dinosaur)

  • Limit testing
  • Non-cooperative
  • Oppositional
  • Insubordinate
  • Contrary
  • Contentious
  • Argumentative
  • Combative
  • Obstinate

.

Essentially, its definition boils down to this criterion: “Failure to comply with directions & routines to an acceptable degree within a tolerable span of time.” (Make note of the teacher tolerance aspect.)  Let’s narrow it down a bit more:

.

Criteria for non-compliance

            Person with authority presents a direction.

    1. Attentive student understood the direction.
    2. Student is capable of performing the action.
    3. Student resisted complying with the direction
    • Within a reasonable period of time (Teacher tolerance)
    • To a reasonable standard (Teacher tolerance)

.

*Quick comprehension quiz: Is the (re)action considered “defiant” if the pupil didn’t understand the direction? (e.g., ELL, short attention span resulting in partial attention, distracted during the direction, language processing issues, etc.)

.

When we humans (I’m including you in that group.) don’t want to comply with a requirement, there are some common choices available to us.

Regarding the last one, “Meet the letter of law, not its intent.”, I remember telling a student to take a seat and sit down.  He picked up the chair, held it close, and sat down on the floor.  Another time, as we were re-entering our classroom, I asked my learners to keep their voices low.  You no doubt know what the youngster said in explanation when I asked him why he was crawling on the floor.)

.

As a teacher, I’m OK with the first two responses on the list.  It’s those other ones that require me to remember “This is a kid.  I’m an adult professional charged with the duty of helping these students make better behavior choices.  This kid needs a competent, caring adult.  I need to be the person that I’d want to see if I were in his/her shoes.”  Indeed, it takes two to tango tangle.

.

The symptoms of ODD as found in DSM-5 (Yes, special education is an alphabet soup of acronyms) include (as you’ll see in the video);

DSM-5 = Diagnostic & Statistical Manual of the American Psychiatric Association (edition #5).  It is one of two texts for determining whether someone has a mental health disorder.  The other one is a section of the World Health Organization’sInternational Classification of Diseases (now in the 11th edition).

.

Reasons for the oppositional behavior that I’ve heard uttered…

The list goes on…

  • Perhaps I’m unknowingly involved in one of those “reality shows” on TV.
  • Part of a vast conspiracy to control the world.
  •             (It’s not paranoia when they really are after you.)
  • Payback for my actions in a previous life.
  • A side effect of global warming.
  • I’m stuck in a bad dream & can’t wake up.

 .

More likely reasons for defiance at any level are related to:

  • Excellent instruction that does not match the student’s:
    • Developmental & academic level
    • Learning style & modalities
    • Feelings, beliefs & values
    • Culture & ethnicity
  • Material is irrelevant to student’s world & aspirations
  • Classroom not inviting enough &/or too threatening
  • Coercion was used in an attempt to gain compliance
  • Overly demanding environment with a focus on precision (versus effort)
  • Overly competitive environment with more losers than winners
  • Teacher’s direction interferes with the student’s present pursuit of a desired goal (completing a task, reaching a stopping point in a game, socializing, pestering another).
  • Directives & assignments are viewed as being:
    • Wrong
    • Unreasonable or a waste of time
  • & youngster’s suggestions/contrary views are given no consideration by the adult.

.

Those etiologies might be exacerbated by:

  • Substance abuse
  • Lack of sleep
  • Physical ailments
  • Emotional disorders
  • Disguise/hide lack of ability or fear of failure
  • Anxiety
  • Perfectionism
  • Co-occurring (I don’t like the word “co-morbid”… sounds fatal.) conditions such as
    • Anxiety
    • Obsessive Compulsive Disorder
    • Depression
    • Counter-culture values

.

  •  Born that way?  How did this child turn into an oppositional one?  

.

After a while, mutual dislike for each other’s responses results in an ingrained pattern of act/react.  Each person plays a continuing role that instigates & escalates problems ala “The Conflict Cycle.

.

Of course, in order to determine the reason, we conduct a Functional Behavior Assessment.  As you well know, behaviors happen for a reason.  There is a “payoff” or benefit that accrues from displaying that behavior.  If there wasn’t an advantage to showing a behavior, we would drop it from our repertoire (excuse my French). Think back to your “tween” and teen years and all the actions that you saw someone else do, thinking that they were “cool”. When that action failed for you, you got rid of it.  OR think of the actions that you displayed proudly as a kid, but now don’t do because you wouldn’t look “pretty” in your princess tiara anymore, or strong in your super hero costume (except on Halloween). During my professional development sessions, why don’t I jump up on a table, grab my butt cheeks, and yell “Whooptie Doo!”  What’s the payoff?  There isn’t one.  Instead, there is punishment in the disapproving eyes and comments of the educators in attendance. (Don’t ask me how I know this.)

.

.

Informational Statistics Regarding Oppositional Defiant Disorder

(copied here verbatim from https://healthresearchfunding.org/18-oppositional-defiant-disorder-statistics/)

1. Up to 16% of adolescents today may have some form of Oppositional Defiant Disorder.
2. ODD usually appears in children when they reach a late preschool or early school age.
3. When children are younger, ODD is more common in boys than in girls. As children age, however, girls and boys share an equal risk of developing this disorder.
4. ODD tends to happen more often in children who live in households that are in lower socioeconomic groups.
5. Oppositional Defiant Disorder can affect children in families that come from any bac kground.
6. About 10% of children will have their ODD officially diagnosed by a medical professional.
7. The percentage of children who have ODD and also have Attention Deficit Hyperactivity Disorder [ADHD]: 40%.
8. 67% of children who receive a diagnosis of ODD will have their behavioral problems resolve within 3 years.
9. 7 out of 10 kids who have ODD do not have any symptoms of the disorder by the age of 18.
10. About 10-30% of kids who have ODD will go on to have some form of a conduct disorder.
11. Kids who develop Oppositional Defiant Disorder before the age of 10 are the most likely to develop a conduct disorder.
12. Another 10% of kids will develop a long-lasting personality disorder, such as antisocial personality disorder [APD].
13. Having ODD increases the risk for a child to develop anxiety issues or depression.
14. More than 70% of the teenagers who went through individual therapy programs showed significant behavioral improvements in just 4 months.
15. Once a child develops a conduct disorder, they have a 40% chance of developing APD as an adult.
16. Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder.
17. Nearly half of kids with ODD will go on to abuse some form of substance later on in their lives.
18. 68% of kids with ODD will exhibit a lifelong struggle with impulse control.

.

General Approaches

  • Be on the lookout for appropriate behavior or attempts to show it (however flawed).  Give positive reinforcement (e.g., smile, thumbs up, compliment, nod of the head) when s/he shows more flexibility or cooperation than previously.  Focus on progress and effort.  Precision will follow.
  • Restrain yourself when you become frustrated.  Remain in calm control of your actions and verbiage.  Take that deep breath and remain consistently calm.  It will prevent escalation of the conflict cycle.
  • Offer choices; ones acceptable to you.  Students then feel that they have power and influence in a situation.
  • Watch your wording: Avoid talking about how continuing the defiance will lead to a harsher consequence(because it suggests that the consequence will indeed occur).  If you must talk about consequences for actions, mention how the student can avoid that outcome by working with you.

 .

HERE’S THE VIDEO!

So let’s put it all together with this case study video in which a student is described before comparing those characteristics to the ODD criteria in the DSM-5, and providing suggestions for intervention.  OH… and all credit goes to one of the wonderful students in my graduate program in teaching kids with mental health & behavior disorders.  These upcoming videos on the various conditions were made by present and future teachers of these youngsters.

 https://www.youtube.com/watch?v=2JJUY2jQQug 

.

.

Other Resources

Read Dr. Mac’s 3-part Blog Post for Free Spirit Publishing (strategies are located in part 3)

 .

Strategies for Dealing with Defiant, Rude & Oppositional Students http://www.behavioradvisor.com/Defiance.html

 .

 .

Do you teach students who exhibit resistance and defiance… failing to follow your routines and directions?  The way that we phrase our utterances, can reduce the “heat” or light the fuse to the emotional power keg.  Bring forth cooperation by phrasing your directions, praise, and commentary in ways that enhance the chances of compliance.  Check out this video series at http://behavioradvisor.com/Webinar.html

.

.

.

Does this particular youngster display defiance at the Tier 3 Level of PBIS?

If so, increase his/her willingness to change his/her behavior for the better.

http://behavioradvisor.com/ReadinessForChange.html

.

Until next time (and even after it), I’m Tom McIntyre, signing off.

Dr. Mac

.

Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in BehaviorDisorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

.

 

.

.

.

.

.

.

.

.

 

.

.

.

.

 Hello again fellow B-Listers!

.

Remember that request to let me know if you have a favored mental health topic for our upcoming series of videos?

 Well, knock me over with a feather duster… Actually, I suspected that it would be the case given my conversations with educators; Oppositional Defiant Disorder was nominated most often to be our first video in the series on mental health and behavior disorders.

.

 ADHD came in second.  Expect to see that video in about a week or so.

.

So… Let’s get started with our video series, and I’ll be certain to eliminate words like the one that sounds exactly like the name for a wall that holds back water.  Many folks who use their organization e-mail addresses found the e-mail being rejected when profanity filters spotted that word.  Dam_!  I didn’t know that it ranked so high on the curse word scale.

.

The video link is found near the end of this write-up.

.

Now I may not be Lamont Cranston (Google it), but I do know what’s on your mind.  You interact with kids who, it often seems, possess life missions to oppose what we propose, and forward objection to our direction. (I can rhyme all the time; I’m a poet and I know it.)  Certainly, all kids (and adults) can be oppositional from time-to-time, particularly when they (we) are tired, stressed-out, hungry, or frustrated. Refusals and back-talk then become the order of the day.  We might expect a certain degree of obstinence from two or three year olds and younger adolescents.  However, public resistance and hostility becomes a must-be-addressed concern when it happens so often an d persistently that it’s undoubtedly two standard deviations from the average for age and developmental level.

.

Call it what you will;  there are many names for it in the Thesaurus (my favorite dinosaur)

  • Limit testing
  • Non-cooperative
  • Oppositional
  • Insubordinate
  • Contrary
  • Contentious
  • Argumentative
  • Combative
  • Obstinate

.

Essentially, its definition boils down to this criterion: “Failure to comply with directions & routines to an acceptable degree within a tolerable span of time.” (Make note of the teacher tolerance aspect.)  Let’s narrow it down a bit more:

.

Criteria for non-compliance

            Person with authority presents a direction.

    1. Attentive student understood the direction.
    2. Student is capable of performing the action.
    3. Student resisted complying with the direction
    • Within a reasonable period of time (Teacher tolerance)
    • To a reasonable standard (Teacher tolerance)

.

*Quick comprehension quiz: Is the (re)action considered “defiant” if the pupil didn’t understand the direction? (e.g., ELL, short attention span resulting in partial attention, distracted during the direction, language processing issues, etc.)

.

When we humans (I’m including you in that group.) don’t want to comply with a requirement, there are some common choices available to us.

Regarding the last one, “Meet the letter of law, not its intent.”, I remember telling a student to take a seat and sit down.  He picked up the chair, held it close, and sat down on the floor.  Another time, as we were re-entering our classroom, I asked my learners to keep their voices low.  You no doubt know what the youngster said in explanation when I asked him why he was crawling on the floor.)

.

As a teacher, I’m OK with the first two responses on the list.  It’s those other ones that require me to remember “This is a kid.  I’m an adult professional charged with the duty of helping these students make better behavior choices.  This kid needs a competent, caring adult.  I need to be the person that I’d want to see if I were in his/her shoes.”  Indeed, it takes two to tango tangle.

.

The symptoms of ODD as found in DSM-5 (Yes, special education is an alphabet soup of acronyms) include (as you’ll see in the video);

DSM-5 = Diagnostic & Statistical Manual of the American Psychiatric Association (edition #5).  It is one of two texts for determining whether someone has a mental health disorder.  The other one is a section of the World Health Organization’sInternational Classification of Diseases (now in the 11th edition).

.

Reasons for the oppositional behavior that I’ve heard uttered…

The list goes on…

  • Perhaps I’m unknowingly involved in one of those “reality shows” on TV.
  • Part of a vast conspiracy to control the world.
  •             (It’s not paranoia when they really are after you.)
  • Payback for my actions in a previous life.
  • A side effect of global warming.
  • I’m stuck in a bad dream & can’t wake up.

 .

More likely reasons for defiance at any level are related to:

  • Excellent instruction that does not match the student’s:
    • Developmental & academic level
    • Learning style & modalities
    • Feelings, beliefs & values
    • Culture & ethnicity
  • Material is irrelevant to student’s world & aspirations
  • Classroom not inviting enough &/or too threatening
  • Coercion was used in an attempt to gain compliance
  • Overly demanding environment with a focus on precision (versus effort)
  • Overly competitive environment with more losers than winners
  • Teacher’s direction interferes with the student’s present pursuit of a desired goal (completing a task, reaching a stopping point in a game, socializing, pestering another).
  • Directives & assignments are viewed as being:
    • Wrong
    • Unreasonable or a waste of time
  • & youngster’s suggestions/contrary views are given no consideration by the adult.

.

Those etiologies might be exacerbated by:

  • Substance abuse
  • Lack of sleep
  • Physical ailments
  • Emotional disorders
  • Disguise/hide lack of ability or fear of failure
  • Anxiety
  • Perfectionism
  • Co-occurring (I don’t like the word “co-morbid”… sounds fatal.) conditions such as
    • Anxiety
    • Obsessive Compulsive Disorder
    • Depression
    • Counter-culture values

.

  •  Born that way?  How did this child turn into an oppositional one?  

.

After a while, mutual dislike for each other’s responses results in an ingrained pattern of act/react.  Each person plays a continuing role that instigates & escalates problems ala “The Conflict Cycle.

.

Of course, in order to determine the reason, we conduct a Functional Behavior Assessment.  As you well know, behaviors happen for a reason.  There is a “payoff” or benefit that accrues from displaying that behavior.  If there wasn’t an advantage to showing a behavior, we would drop it from our repertoire (excuse my French). Think back to your “tween” and teen years and all the actions that you saw someone else do, thinking that they were “cool”. When that action failed for you, you got rid of it.  OR think of the actions that you displayed proudly as a kid, but now don’t do because you wouldn’t look “pretty” in your princess tiara anymore, or strong in your super hero costume (except on Halloween). During my professional development sessions, why don’t I jump up on a table, grab my butt cheeks, and yell “Whooptie Doo!”  What’s the payoff?  There isn’t one.  Instead, there is punishment in the disapproving eyes and comments of the educators in attendance. (Don’t ask me how I know this.)

.

.

Informational Statistics Regarding Oppositional Defiant Disorder

(copied here verbatim from https://healthresearchfunding.org/18-oppositional-defiant-disorder-statistics/)

1. Up to 16% of adolescents today may have some form of Oppositional Defiant Disorder.
2. ODD usually appears in children when they reach a late preschool or early school age.
3. When children are younger, ODD is more common in boys than in girls. As children age, however, girls and boys share an equal risk of developing this disorder.
4. ODD tends to happen more often in children who live in households that are in lower socioeconomic groups.
5. Oppositional Defiant Disorder can affect children in families that come from any bac kground.
6. About 10% of children will have their ODD officially diagnosed by a medical professional.
7. The percentage of children who have ODD and also have Attention Deficit Hyperactivity Disorder [ADHD]: 40%.
8. 67% of children who receive a diagnosis of ODD will have their behavioral problems resolve within 3 years.
9. 7 out of 10 kids who have ODD do not have any symptoms of the disorder by the age of 18.
10. About 10-30% of kids who have ODD will go on to have some form of a conduct disorder.
11. Kids who develop Oppositional Defiant Disorder before the age of 10 are the most likely to develop a conduct disorder.
12. Another 10% of kids will develop a long-lasting personality disorder, such as antisocial personality disorder [APD].
13. Having ODD increases the risk for a child to develop anxiety issues or depression.
14. More than 70% of the teenagers who went through individual therapy programs showed significant behavioral improvements in just 4 months.
15. Once a child develops a conduct disorder, they have a 40% chance of developing APD as an adult.
16. Of those with lifetime ODD, 92.4% meet criteria for at least one other lifetime DSM-IV disorder.
17. Nearly half of kids with ODD will go on to abuse some form of substance later on in their lives.
18. 68% of kids with ODD will exhibit a lifelong struggle with impulse control.

.

General Approaches

  • Be on the lookout for appropriate behavior or attempts to show it (however flawed).  Give positive reinforcement (e.g., smile, thumbs up, compliment, nod of the head) when s/he shows more flexibility or cooperation than previously.  Focus on progress and effort.  Precision will follow.
  • Restrain yourself when you become frustrated.  Remain in calm control of your actions and verbiage.  Take that deep breath and remain consistently calm.  It will prevent escalation of the conflict cycle.
  • Offer choices; ones acceptable to you.  Students then feel that they have power and influence in a situation.
  • Watch your wording: Avoid talking about how continuing the defiance will lead to a harsher consequence(because it suggests that the consequence will indeed occur).  If you must talk about consequences for actions, mention how the student can avoid that outcome by working with you.

 .

HERE’S THE VIDEO!

So let’s put it all together with this case study video in which a student is described before comparing those characteristics to the ODD criteria in the DSM-5, and providing suggestions for intervention.  OH… and all credit goes to one of the wonderful students in my graduate program in teaching kids with mental health & behavior disorders.  These upcoming videos on the various conditions were made by present and future teachers of these youngsters.

 https://www.youtube.com/watch?v=2JJUY2jQQug 

.

.

Other Resources

Read Dr. Mac’s 3-part Blog Post for Free Spirit Publishing (strategies are located in part 3)

 .

Strategies for Dealing with Defiant, Rude & Oppositional Students http://www.behavioradvisor.com/Defiance.html

 .

 .

Do you teach students who exhibit resistance and defiance… failing to follow your routines and directions?  The way that we phrase our utterances, can reduce the “heat” or light the fuse to the emotional power keg.  Bring forth cooperation by phrasing your directions, praise, and commentary in ways that enhance the chances of compliance.  Check out this video series at http://behavioradvisor.com/Webinar.html

.

.

.

Does this particular youngster display defiance at the Tier 3 Level of PBIS?

If so, increase his/her willingness to change his/her behavior for the better.

http://behavioradvisor.com/ReadinessForChange.html

.

Until next time (and even after it), I’m Tom McIntyre, signing off.

Dr. Mac

.

Tom McIntyre, Ph.D. (Dr. Mac)

Professor of Special Education and Coordinator of the Graduate Program in BehaviorDisorders

Hunter College of the City University of New York

DoctorMac@BehaviorAdvisor.com

.

 

.

.

.

.

.

.

.

.

 

.

.

.

.