Oppositional Defiant Disorder

Background

While oppositional defiant disorder (ODD) was added to the DSM in the 1980s, its existence and diagnosis is still hotly debated and somewhat misunderstood among families and educators. Surprisingly enough, ODD is one of the most common behavioral disorders to be diagnosed in children. Furthermore, researchers have also found that oppositional defiant disorder in both boys and girls is often accompanied by a previous ADHD diagnosis.

 

Symptoms

While ODD is a disorder that affects both boys and girls, symptoms are typically known to vary between the sexes. Though this is in no way absolute, researchers have found that boys with ODD display their opposition and defiance in more physically aggressive manners; their frustrations may escalate quickly and in more overtly explosive ways. While girls, on the other hand, are more likely to display oppositional or defiant behaviors in subtle, sneaky, or manipulative ways. For instance, girls with ODD may be deceitful or cunning and interact with others in intentionally uncooperative ways. Again, these are not hard and fast rules; they are simply some of the known observations experts have made between the genders.

 

It is also important to note that symptoms associated with ODD are typically misbehaviors that most children and teens will display at some point during their development. However, the difference between mere misbehaviors or teenage moodiness and ODD is the prevalence and severity of the behaviors. With regard to a diagnosis, ODD behaviors have likely become so frequent that they are deemed as the “norm” for that child.

 

Support in the Classroom

Behavior Support Additional Considerations
Disproportionate anger/frustration/

irritability

  • Provide student with flash pass to the counselor for when tempers flare
  • Allow student to take brief “brain breaks” throughout the day, especially when transitioning between activities or subject areas to alleviate stress
  • Provide student with preferential seating near the door for easy access to the hallway if frustration escalates
  • Provide student with fidget cube or stress ball to channel negative energy
  • Classrooms as a whole can benefit from stress-relieving or meditative practices, but these coping skills are especially beneficial to students with ODD; schools and counselling departments are beginning to focus students’ attention on mental self-care and coping methods to reduce anxiety and stress
Argumentative, uncooperative, defiant towards adults/authority figures
  • Present requests or directives in the form of an “either/or” question. For example, if a student throws paper off the desk, the teacher might say, “Would you like to either pick up the paper now, or pick up all scrap paper at the end of class?”
  • Remind student that his/her defiance is a choice that will result in a consequence; ask him/her if she would like to make a different choice to amend the tone/behavior/attitude
  • Stay calm; you cannot fight fire with fire. As difficult as it may be, teachers and other adults must remember that the ODD behaviors are stemming from a larger issue.
  • Deescalate the tone of the situation by maintaining a calm, understanding, yet firm demeanor. Act with care and be deliberate in your directives toward the student.
  • Remind students that you are there FOR THEM; everything you do is meant to ensure safety and success in the classroom. By reaffirming your desire to help him/her, a defiant student may soften the edge and be more receptive to your requests.
Physical aggression; vindictive, spiteful, or manipulative behavior
  • Physical altercations are never okay; remind students that verbal disagreements should never escalate to physical interactions
  • If something physical does transpire, adults must be sure to document the situation thoroughly. This includes all parties involved, what instigated the issue, and anyone who may have witnessed the altercation. Teachers should also note when and where the event took place so that administration and parents are made aware of the full situation.
  • Teachers can consider activities or brain breaks that either diffuse or expel aggression or anger.
  • Items such as Rubik’s cubes, coloring books, or sudoku challenges help students to come down off of the aggressive moment by occupying the mind
  • Consider creating a small, comfortable, secluded corner of the room where students can take a breath and collect themselves before re-entering the classroom environment
  • Teachers and guidance counselors can help to mediate aggression and manipulative behaviors by helping students to reflect on an incident. Prompt students to think about why they lied, cheated, manipulated, etc. Ask them what they could have done differently that would have resulted in a more positive outcome.

Testing Accommodations

Testing accommodations should help students two-fold. Accommodations should provide support for students to access material and demonstrate mastery, and they should also foster a sense of confidence and boost students’ ability to advocate for themselves. When students feel successful, especially on an assessment, that confidence is magnified and motivates students that may have been discouraged by their learning differences. It is likely that students who struggle with a learning disability look unfavorably at their ability to test well. This does not have to be the case. With testing accommodations, students can reach their full potential and truly thrive.

Executive Functions Disorder:

Of course, accommodations should be tailored to each learner’s specific needs—that is why plans are called IEPs, or individualized education programs. These tools are tailored to each individual student, as there are certain accommodations that are known to assist certain styles of learners better than others. For students with executive function difficulties, testing accommodations can changes testing woes into wins.

Because students with executive functioning disorder struggle specifically with tasks involving higher-level thinking skills, testing accommodations remove unnecessary obstacles so that students can demonstrate an accurate picture of their knowledge. For example, some students may lack confidence when it comes to multiple choice questions. It is not that he/she lacks the knowledge or skills to arrive at the correct answer, it is simply that the ability to eliminate incorrect answers becomes a major distraction.

Provide students with three answer options as opposed to four—this makes the task of elimination less daunting.

Prompt students to physically cross or scratch out the answers that they know are incorrect; reminding them of this test-taking strategy can sometimes be all the help students need.

Allow students to mark or bubble their options right on the test booklet, as opposed to transferring them to a Scantron or bubble sheet. This eliminates the possibility that they will bubble the wrong answer or unintentionally skip questions.

Encourage students to highlight, underline, or mark certain parts of the question or answer options that stand out as crucial to the question. For example, if a question asks “What is not one of the author’s purposes for writing the text?” prompt students to recognize and mark the word not to reinforce the fact that they are looking for a non-answer.

Practice explicit, direct instruction of common testing terms such as analyze, organize, complete, develop, process, etc. These concepts are difficult for all students in the sense that they require abstract thinking. However, for students with executive functioning disorder, these types of cognitive skills are the precise functions that they struggle with specifically. If a test question asks them to “assess the use of the term” consider rewording the question or providing a footnote to explain what you mean by assess.

If students are asked to organize a paragraph in response to a prompt, provide them with a graphic organizer. This small modification helps students to get the ball rolling when constructing their response. They are still tasked with writing the response; however, the intimidation factor is eased by the fact that they have a scaffold form which to work.

Similarly, providing students with sentence frames in addition to a graphic organizer can help ease the stress of a written response. Since executive function disorder is often marked by the inability to or difficulty with organizing thoughts and conveying them in written form, sentence frames provide students with a starting point and allow them to show that they have mastered the concept without the cognitive output interfering.

ADHD for Parents: Looks Can be Deceiving

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The Center for Disease Control reports that over 10 percent of children and teens suffer from attention deficit hyperactivity disorder (ADHD).  Even more shocking, many cases go unreported or are misdiagnosed, providing families with improper information and treatment options. With such a prevalence of attention difficulties among America’s youth, it is no wonder that the disorder can easily be misunderstood or misjudged.

For parents, this unknown or variable aspect of attention deficit hyperactivity disorder can be frustrating. Since every child is unique, children who suffer from ADHD may exhibit drastically different symptoms from one another. What many parents do not know is that ADHD does not have just one cause, or cure, or treatment. Other prevalent myths about ADHD are listed below, as we seek to understand what this disorder is—and what it is not.

  • Myth #1: ADHD mostly affects children at school. This is simply not the case. Children are often diagnosed once they hit school age, typically around age 6-7. While ADHD is most obvious in school because of the attention needs and self-control that is necessary to complete classroom activities, the disorder is not solely confined within the walls of the school. Any activity or conversation, whether academically-related or not, will be difficult for a child with attention issues. This impulsivity, inattentiveness, or lack of focus can happen anywhere—the car, the house, while having a conversation, or even when playing a game or watching a movie.
  • Myth #2: ADHD reflects a lack of care or eagerness on behalf of the child. Again, this is false. In fact, children with ADHD, when made self-aware of their inattentiveness, work even harder to compensate for the lack of focus. Imagine trying to watch a television show while listening to music using headphones. This is similar to how students feel in a classroom when multiple conversations are occurring at once. The multi-sensory distractions become so overwhelming that tuning out is the only reasonable option.
  • Myth #3: Children will outgrow the attention disorder. Unfortunately, this is not the case either. While children and teens, with appropriate behavioral and/or medical interventions, may better manage their symptoms as time passes, the disorder is never truly absolved
  • Myth #4: ADHD is considered a major roadblock when it comes to success in academia and in the work force. NOT TRUE. While the condition is titled a “deficiency,” ADHD has its own unique set of advantages, as well. If children and young adults learn to channel the disorder properly, the hyperactivity can be transformed into hyper-focus. That said, a person with ADHD may be able to focus on a difficult task for hours on end—determined to finish or solve the problem. ADHD also forces children to be self-sufficient and self-aware. Often times, after managing the disorder in school for a while, children learn to self-check and gauge their own level of attentiveness. They also find it easier to pick themselves up after setbacks or missteps. Similarly, people with ADHD are often forced to think or learn a little differently—their success is determined by the ability to streamline information, block out insignificant details, and question their comprehension of the task. Therefore, a person with ADHD will often hone these practices and exhibit ingenuity, creativity, and resourcefulness. ADHD should not be seen as a wholly detrimental learning disorder— in fact, people can use the symptoms to their advantage with practice and patience.

ADHD MONTH: Looks can be deceiving

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Since the classroom environment lends itself to tasks involving focus, attentiveness, attention to detail, cooperative learning, and time management skills, educators are sometimes the first to notice the growing prevalence of attention deficit hyperactivity disorder (ADHD) and the symptoms that accompany the disorder. More and more children are exhibiting attention issues in and out of the classroom—the CDC reports that over 10 percent of children and teens have ADHD. With this significant percentage of cases comes just as many ways for the disorder to manifest itself—and every child is different.

As educators, we pretty much get a daily bird’s eye view of how each student learns, or struggles to learn. Even so, we occasionally (and inadvertently) forget that attention deficit hyperactivity disorder can reveal itself in drastically different ways. On a personal note, just last week, I held a student after class to discuss his constant roaming around the classroom. After asking him to be seated several times during instruction, my patience had admittedly dwindled.

He very calmly and candidly explained that, especially during the long block periods, he finds it difficult to focus while seated at his desk for too long. While this particular student did not show up to my class with documentation of an attention disorder, his need to move, at first misunderstood, is no less legitimate.

As demonstrated above, students with ADHD symptoms can be mistaken as disruptive, disinterested, disorganized, etc. It is important to be mindful of the catalysts to those behaviors—i.e., what do these behaviors truly mean?

ASSIGNMENT COMPLETION

When a student’s focus drifts during class or at home, assignments can be left by the wayside, going uncompleted or altogether neglected. Educators need to distinguish the difference between carelessness or disinterest and a student’s tendency to be distracted and drift. An incomplete project or homework assignment does not necessarily signify a lack of attempt. Anything from noise in the classroom to a transition during instruction can deter a student’s focus, making it difficult for him or her to complete the assigned work in the provided block of time. Again, this is not due to laziness or lack of interest.

Group work can also add a layer of difficulty to assignment completion. Students with ADHD can benefit from the conversation and movement that group work provides. However, these components can be just as equally distracting if the group’s conversation shifts off task. The group work can become overwhelming to the point that the student will drift and separate from the group. Again, this is not indicative of the student’s unwillingness to participate.

BEHAVIOR

As in the case of my “wandering student” above, children and teens with attention deficit hyperactivity disorder often find it beneficial to move about the room. This constant need to move is not only distracting to other students, but may also be seen as an avoidance technique. While this may be true in some cases, most often the student is moving because it helps him to focus or expend any excess energy. Frequent breaks, rotation stations, or standing and working from a clipboard are all methods to help alleviate the need to roam. These small bouts of movement also allow the student to focus.

If a student appears to be reading, doodling, or is otherwise “off task,” it may not be an indication that she is intentionally ignoring instruction or avoiding work. These seemingly defiant behaviors are actually a method of channeling a student’s focus—a self-soothing method, if you will. For some students, especially those with ADHD, putting their hands to work is a way of keeping themselves centered and attentive. A stress ball is also helpful for students whose attention is benefited from multitasking.  

As educators, we need to focus our attention not only on what we are teaching, but also to whom we are teaching. By paying careful attention to the learning needs and styles of our students, we can not only help our easily distracted students to learn more effectively, but also improve the overall learning environment for our entire class.