View stunning SlideShares in full-screen with the new iOS app!Introducing SlideShare for AndroidExplore all your favorite topics in the SlideShare appGet the SlideShare app to Save for Later — even offline
View stunning SlideShares in full-screen with the new Android app!View stunning SlideShares in full-screen with the new iOS app!
Where it can go Wrong Intensity Aggression Becomes destructive Timing A time and a place for it Planning/Process How to approach the situation Consideration of others involved Pros and Cons Cost/benefit
Behavior on a Continuum Moderate Dependent, Helpless, Victim Aggressive, Hurtful, Antisocial
Disruptive Behavior Disorders Oppositional Defiant Disorder Conduct Disorder Disruptive Behavior Disorder NOS Antisocial Personality Disorder Reserved for Adults
Oppositional Defiant Disorder A. A pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which four (or more) of the following are present: (1) often loses temper (2) often argues with adults (3) often actively defies or refuses to comply with adults' requests or rules (4) often deliberately annoys people (5) often blames others for his or her mistakes or misbehavior (6) is often touchy or easily annoyed by others (7) is often angry and resentful (8) is often spiteful or vindictive B. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. C. The behaviors do not occur exclusively during the course of a Psychotic or Mood Disorder.
Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association
What Else Can Look LikeOppositional Defiant Disorder? Autism Spectrum Anxiety Depression Bipolar Disorder Trauma History Developmental Issues
How Do Children Develop Extreme Defiance? Bio-psycho-social explanation Bio = Biological reasons Psycho = Psychological Social = History, Environmental Within the Psychological domain we explore the “why” behind the behavior What MOTIVATES defiance?
Behavioral Reasons for It to Get Out of Control The child has LEARNED that extreme defiance “works” He throws a fit and ends up getting his way Learned by example Over time this behavior is strengthened through success Risk/Reward or Cost/Benefit
Cognitive Reasons for It to Get Out of Control “I have to get you before you get me.” “Everyone is against me.” “The more I push, the more I get.” “I’ve been hurt so much already that I don’t care what happens to me.” “I have no control. I will do what it takes to have control.”
Things that Don’t Seem to Work What things have you tried that didn’t seem to work very well? Have you ever “won” an argument? What about power struggles? How do your own actions influence the situation? STUDY LINK: http://www.aera.net/uploadedFiles/News_Media/News_Releases/2010/AERA%20Factsheet-3%20April8-2010.pdf
What Can We Do? Set up a simple and Consistent set of expectations Learn to manage ourselves Use our skills and supports Self-regulation Skill Training Physical Emotional Cognitive
“Know Thyself” Socrates - 469 BC – 399 BC Benjamin Franklin wrote in his 1750 Poor Richard's Almanac that "There are three things extremely hard: steel, a diamond, and to know one's self.“
“Know Thyself” How do you think about children who are oppositional or defiant? What perceptions do we form about others? What do we attribute their behavior to? What do we think about our own ability to manage these types of behaviors? How do we respond under stress?
Having a Solid Framework Gives you guidance when you get stuck Helps you evaluate new interventions/activities Helps the Team Communicate Prevents Confusion Helps provide Consistency
Self-regulation & Violence School Safety Violence & Aggression Victim/Perpetrator What are the connections?
Assumptions of the Framework Children will do well if they can (Green & Ablon, 2006). One must be physically calm to effectively engage in problem-solving and learning (Goleman, 1998, Macklem, 2008 ,Yerkes & Dodson, 1908). Human beings have little control over their environment, but a great deal of control over their responses to their environment (Ellis, 1962). The relationship is likely the most important variable when trying to help someone change (Hubble, Duncan & Miller, 1999).
Assumptions of the Framework Cognitive-behavioral psychology works (Beck & Fernandez, 1998; Butler, Chapman, Forman & Beck, 2006). Effective Self-regulation is critical for success and happiness (Baumeister, Heatherton, & Tice, 1994; Duckworth & Seligman, 2005; Masten & Coatsworth, 1998). In order to be effective, we need to meet children where they are currently functioning (Greene, 2006; Bailey, 2001). Do not assume that children have learned anything about how to regulate their own behaviors in a healthy way.
Cognitive-behavioral Psychology Works Cognitive-Behavioral Psychology Over 400 Random, Clinical studies Easy to Use Natural to implement – probably doing some of it already De-mystifies psychology High emphasis on education Stresses monitoring and outcomes
Cognitive-Behavioral Psychology in a Nutshell Behavioral Setting up consistent limits with consequences Rewarding positive behaviors Cognitive Understanding that beliefs and perceptions dictate our emotional and behavior responses Change beliefs to change behavior
What is the Goal? Self-Regulation Age External Regulation Age
Self-regulation Broadly defined Skill-building Scaffolding Learning to regulate one’s own Physical, Emotional, and Cognitive processes in healthy, pro-active ways to be successful Healthy, adaptive and “appropriate” responding to internal and external events
Three Functional Categories of Self-regulation Skill Training Physical Emotional Cognitive
Physical Regulation When Physical response is triggered: Lower Brain is in command Higher thinking not engaged Body is ready for action Performance requiring thought is compromised Learning is decreased Problem-solving is decreased Yelling, screaming, pushing, hitting, kicking, biting, throwing things, spitting, “shutting down”, etc. People can get hurt http://www.youtube.com/watch?v=trPuXkbTpok
Physical Regulation Goals of Physical Strategies: Moderate the Fight/Flight/Shut-down ; Autonomic system Move back “up” from the brain-stem Return body to baseline Physical Strategies include: Repetitive movements Stretching Change of physical position Breathing Relaxation Distraction Biofeedback Can take advantage of Imagination and Visualization – Suggestion, Association
Physical Training Do: Remove Stimulation Practice and Prevention Reduce Stress Give Space Calming Exercises Rhythmic Repetitive Movements and Stretching Do Not: Try to teach Argue Lecture Win Prove a point
My Physical Strategies Break into small groups and identify as many activities as you can to address Physical Regulation Goals of Physical Strategies: Moderate the Fight/Flight/Shut-down ; Autonomic system Move back “up” from the brain-stem Return body to baseline Physical Strategies include: Repetitive movements Stretching Change of physical position Breathing Relaxation Distraction Biofeedback Can take advantage of Imagination and Visualization – Suggestion, Association
Emotional Training Goals of Emotional Strategies: Accurately identify emotions; our own and those of others Own and accept responsibility for our feelings Expressing feelings in healthy, appropriate ways Emotional Strategies Include: Labeling Expression training Responsibility for feelings
My Emotional Strategies Break into small groups and identify as many activities as you can to address Emotional Regulation Goals of Emotional Strategies: Accurately identify emotions; our own and those of others Own and accept responsibility for our feelings Express feelings in healthy, appropriate ways Emotional Strategies Include: Labeling Expression training Responsibility for feelings
Cognitive Training Goals of Cognitive regulation: Problem-solving skills Engaging higher cortical areas of the brain Planning and organization skills Insight and Understanding Forming healthy beliefs about ourselves and the world around us Cognitive Strategies include: Specific training to problem areas Ex. – Collaborative Problem Solving for Conflict Resolution Insight-oriented teaching to promote understanding Learning about his/her own patterns of behavior
Cognitive Training Common beliefs: “I have to get you before you get me.” “Everyone is against me.” “The more I push, the more I get.” “I’ve been hurt so much already that I don’t care what happens to me.” “I have no control. I will do what it takes to have control.”
Specific Scenario What about the other Complicating Factors? Crowded classroom with lots of eyes and ears Pressure of completing the “task at hand” Academic standards Lack of other adults Our own upset and other internal factors The child’s unknown history /abilities
Johnny 10-year-old boy Often disruptive in class with frequent anger outbursts When angry, he stays agitated for over an hour and continues to struggle in class Can be triggered by other students or the teacher believes that “things have to be a certain way or else” and it is obvious that he does not believe he has control over his actions and he believes that others “make” him angry and can be openly defiant Grades are C’s and D’s and cognitive abilities are average for his age Single-parent home with similar behaviors being reported at home
Creating an Individualized Planfor Change Complete baseline assessment Select Physical, Emotional and Cognitive Strategies to match child’s interests and behaviors Engage child, team and parents if possible Sell the change - Simple - Just a few meetings
Create Your Plan Get into groups Develop a plan to help Johnny increase his ability to Self-regulate Use Physical, Emotional, and Cognitive Strategies
Don’t Forget Self-Assessment What baggage did you bring to the party?
2 Physical Strategies My Warning Signs Melting Freeze
Additional Tips Use Natural Consequences when you can Be Strengths-based For strategies, use things that you and the child are interested in Programs like Challenge Software can engage children quickly Understanding goes a long way