Oppositional Defiant Disorder (ODD) info & video

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Aug 172018
 

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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

.

 

.

.

.

.

.

.

.

.

 

.

.

.

.