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Oppositional Defiant Disorder Brendan Schweda Definitions 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 student’s educational performance (as seen in the NYS Regs): - An inability to learn that cannot be explained by intellectual, sensory, or health factors. - An inability to build or maintain satisfactory interpersonal relationships with peers and teachers - Inappropriate types of behavior or feelings under normal circumstances - A generally pervasive mood of unhappiness or depression; or - A tendency to develop physical symptoms or fears associated with personal or school problems. Specific DSM IV ODD Criteria For at least 6 months, shows defiant, hostile, negativistic behavior; (4 or more of the following): -Losing temper -Arguing with adults -Actively defying or refusing to carry out the rules or requests of adults -Deliberately doing things that annoy others -Blaming others for own mistakes or misbehavior -Being touchy or easily annoyed by others -Being angry and resentful -Being spiteful or vindictive Causes *The exact cause of ODD is not known.* Some researches believe that cause may be related to certain biological and environmental factors, such as: • A child’s temperament and the family’s response to it • A child’s social skills • A child’s ability to communicate through language • How parents discipline and understand the child • The way a child’s body adjusts to arousal and stimulation Having parents who are overly concerned with power and control Disruptive childcare An inherited disposition to the disorder, possibly both environmental as well as genetic Neurological damage A Few Facts Studies show that five to 15% of all school-age children have ODD All children display most of these behaviors from time to time ODD does not usually exist alone: Fifty to sixty-five percent of children with ODD have ADHD 35% develop some form of affective disorder 20% have some form of mood disorder 15% develop some form of personality disorder Connection to Conduct Disorder • Conduct Disorder (in DSM-IV): “repetitive and persistent pattern of behavior in which either the basic rights of other or major age-appropriate societal norms or rules are violated.” • In the DSM-IV, a diagnosis of CD preempts a diagnosis of ODD. *Focus on ODD symptoms may help prevent CD. However, some clinicians state that the relation of ODD to CD may be overstated. Diagnosis If a doctor suspects ODD, he or she will first: - Talk with the child and with their parents. - Review the child’s and the family’s history. - Obtain information about the child’s functioning in school. - Look for signs of other disorders in the child. Treatment *Major treatments for ODD exclude medication* • Parental Training • Family Psychotherapy • Social Skills Training • Cognitive-behavior Therapy • Child Psychotherapy Academic Modifications • Systematically teach Social Skills • Make sure academic work is at the appropriate level • Select Materials that encourage student Interaction • Pace Instruction • Post the Daily Schedule • Minimize downtime and plan transitions carefully • Allow the ODD student to redo assignments References: Sutton, James D. “The ODD Page.” DocSpeak. Ed. James Sutton. 10 Oct. 2006. <http://www.docspeak.com/ODD/index.htm>. Baugh, C. “Oppositional Defiant Disorder”. Spsk12. 1 Oct. 2006. Shaffer, Rick. “Difficult or Defiant: Understanding Oppositional Defiant Disorder.” Parenthood. 1 Oct. 2006. <http://www.parenthood.com/articles.html?article_id=6960&printable=t rue>. Kann, R. Traci; Hanna, Fred J. ”Behavior Disorders in Children and Adolescents: How Do Girls Differ from Boys?” Journal of Counseling & Development v78 n3 (2000): p267-74 Johnson, James H. “Oppositional Defiant and Conduct Disorder.” <www.hp.ufl.edu/~jjohnson/ODD.ppt> Webb, James T. “Mis-Diagnosis and Dual Diagnosis of Gifted Children.” Annual Conference of the APA. (2000)