Oppositional Defiant Disorder

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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.

PTSD Awareness Month

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Post-Traumatic Stress Disorder (PTSD) is often associated with returning war veterans or first responders. However, children and teens are at a significant risk, as well. Because a child’s emotional coping responses develop as they age, they may be even more prone to symptoms of PTSD after a traumatic event. Thus it is imperative that parents and educators know the signs of PTSD in children and teens.

According to the Anxiety and Depression Association of America, PTSD is diagnosed after a person experiences the three main types of symptoms for at least one month following a traumatic event:

      –  Re-experiencing the trauma through intrusive distressing recollections of the event, flashbacks, and               nightmares.

      –  Avoidance of places, people, and activities that are reminders of the trauma, and emotional numbness.

      –  Increased arousal such as difficulty sleeping and concentrating, feeling jumpy, and being easily irritated and angered.

So, what should educators look for? PTSD in children and teens most frequently occurs when the child has witnessed or experienced a violent or dangerous event. Most common reasons that a child may develop PTSD involve death or injury of a parent or loved one, witnessing or experiencing physical or sexual abuse, and any unexpected disaster, including a car crash, house fire, etc.

The National Center for Post-Traumatic Stress Disorder estimates that anywhere from three million to 10 million children and teens witness violence in the home every year. Since domestic and child abuse is largely underreported, the true number of cases is thought to be even higher. That said, identifying PTSD involves vigilance, as every child copes and expresses emotions differently. For teachers and family members, it is important to have all of the necessary information when dealing with children suffering from PTSD.

To be proactive, adults in the child’s life should be informed about any recent trauma or violent event. Children may exhibit avoidance behaviors when something reminds them of the traumatic event. Any sort of flashback or familiarity of the event could cause extreme distress, agitation, or anxiety. Therefore, it is especially important that teachers know which subjects to avoid discussing in class, as certain topics could trigger an unpleasant memory or flashback.

Also, loud noises or sudden changes in the environment could cause flashbacks and emotional distress. Children may exhibit this distress by crying, shaking, appearing jumpy or skittish, etc. This hypervigilance is an attempt to foresee the possibility of another traumatic event. It is as though the child is expecting violence or danger at any moment. This sort of hypervigilance can cause sleeplessness, lack of focus, anxiety, and severe shifts in behaviors and emotions.

While some children may exhibit extreme temper tantrums, others may cope in an opposite manner. In an effort to self-soothe, some children may refuse to speak or fail to respond to comfort. In some cases, children and teens with PTSD exhibit selective mutism, in which they refuse to speak, interact, or make eye-contact with anyone.

Since symptoms and age of onset of Post-Traumatic Stress Disorder vary from child to child, treatment options are just as diverse. Some cases of PTSD in children have been known to dissipate on their own after a few months. However, it is not recommended that PTSD symptoms be ignored in the hopes that the condition will fix itself. Different therapy options, such as cognitive behavior therapy, crisis management therapy, and play therapy offer various methods for children and teens to confront past trauma. The most important thing that parents and teachers can do is be vigilant and aware of behavioral, academic, and emotional changes in the child.