BREAKING DOWN THE WALLS: REACHING THE DEFIANT CHILD
Without love or caring in a child’s life, a disconnected hollow shell is likely to evolve- a living cavity without conscie...
ATTACHMENT DISORDER OPPOSITIONAL DEFIANCE DISORDER CONDUCT DISORDER ATTENTION DEFICIT HYPERACTIVITY DISORDER EMOTIONAL IMP...
THE NATURE OF ATTACHMENT Presented by Steven Vitto
<ul><li>The National Adoption Center reports that 52% of adoptable children have attachment related atypical behavioral sy...
“ AN ATTACHMENT FORMS BETWEEN INFANT AND PRIMARY CAREGIVER SOMETIME DURING THE INFANT’S FIRST TWO YEARS OF LIFE.”
Attachment is the “lasting psychological connectedness between human beings.”
“ The quality of our attachment acts as a foundation for our future.”
The Basic Function of Secure Attachment <ul><li>Learn basic trust and reciprocity. </li></ul><ul><li>Explore the environme...
“ AN ATTACHMENT DISORDER OCCURS WHEN THE ATTACHMENT PERIOD IS DISRUPTED OR INADEQUATE, LEAVING THE CHILD WITH THE INABILIT...
Risk Factors for Developing   Attachment Disorders. <ul><li>Maternal ambivalence towards pregnancy. </li></ul><ul><li>Sudd...
Risk Factors  (Continued…) <ul><li>Traumatic prenatal experience (in-utero exposure to alcohol/drugs).  </li></ul><ul><li>...
DSM-IV RAD DEFINITION <ul><li>A markedly disturbed and developmentally inappropriate social relatedness in most contexts, ...
Characteristics or Symptoms of Attachment Disorder: <ul><li>Superficially charming: uses cuteness to get her or his way. <...
<ul><li>Has difficulty making and keeping friends. </li></ul><ul><li>Speech and language problems. </li></ul><ul><li>Overa...
Diagnosing Attachment Disorder
Attachment Checklists <ul><li>Three types of Adult/child self-report </li></ul><ul><ul><li>Parents record child’s behavior...
Compromised Brain Development <ul><li>Ross Green (The Explosive Child) suggests that there is compelling evidence to sugge...
DIAGNOSIS??? It is  important to remember that a diagnosis is not a scientific fact. It is a considered opinion based upon...
Prognosis: <ul><li>Eighty percent of children with Oppositional Defiance Disorder showed insecure attachment. </li></ul><u...
What the research says about overcoming the effects of insecure or interrupted attachment. <ul><li>Prognosis is Tenuous </...
OPPOSITIONAL DEFIANCE DISORDER
All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk ...
What is Oppositional Defiance Disorder? ODD is a persistent pattern (lasting for at least six months) of negativistic, hos...
ODD DEFINED <ul><li>The key distinction from other types  </li></ul><ul><li>of conduct disorder is the absence  </li></ul>...
Oppositional Defiance Disorder <ul><li>ODD is a nondelinquent conduct disorder </li></ul><ul><li>ODD occurs in about 6% of...
What are the Symptoms of Oppositional Defiance Disorder? <ul><li>Frequent loss of  temper;  </li></ul><ul><li>Arguing with...
Oppositional Defiance Disorder <ul><li>Being touchy or easily annoyed </li></ul><ul><li>Being angry and resentful </li></u...
It is important to distinguish between a won’t problem and a can’t problem <ul><li>Can be difficult to assess </li></ul><u...
Contra-Indicated Behavioral Strategies for the ODD Child <ul><li>Ultimatums </li></ul><ul><li>Strict Boundaries: Drawing t...
What Causes Oppositional Defiance Disorder? <ul><li>The cause of Oppositional Defiant Disorder is unknown at  </li></ul><u...
Contributing Factors <ul><li>Parents and teachers who impose inconsistent ---harsh punishment mixed with lax, inconsistent...
Russell Barkley’s 4-Factor Method: Etiology of ODD <ul><li>Factor 1:  </li></ul><ul><li>The child’s or teen’s characterist...
Factor #1: The child or teen’s characteristics-Temperament <ul><li>Temperament is behavioral style ; it is the characteris...
Responding to Temperament   <ul><li>Expert parenting or teaching not seen as acting according to a set of general rules. <...
Temperament   <ul><li>Largely determined by genetic factors. </li></ul><ul><li>Shows considerable stability over time. </l...
Nine traits that Contribute to Temperament  <ul><li>1. ACTIVITY:  the amount of physical motion during sleep, eating, play...
Temperamental Traits  <ul><li>4. ADAPTABILITY:  the ease or difficulty with which reactions to stimuli can be mod-ified in...
Temperamental Traits   <ul><li>7. PERSISTENCE AND ATTENTION SPAN:  the length of time particular activities are pursued by...
Child Unhappy at Her Own Birthday Party
Why was this little girl’s party a failure? Overlooking Temperament  <ul><li>High intensity (expresses emotions in a stron...
Temperamental Traits of This Particular Child  <ul><li>Poor adaptability (has trouble with transition and change of routin...
Factor 2 The Parent’s Characteristics <ul><li>Physical and temperamental characteristics </li></ul><ul><li>Psychiatric dis...
Factor 3 The Family’s Environment and Family Stress <ul><li>Economic Status </li></ul><ul><li>Housing </li></ul><ul><li>Jo...
Factor 4 Parenting/Teaching Style <ul><li>Inconsistent consequences </li></ul><ul><li>Lack of positive attention or reinfo...
Our Need for Power and Control
Underlying Systems of Control in School <ul><li>The use of reinforcement </li></ul><ul><li>Response Cost-loss of privilege...
How should ODD be evaluated? <ul><li>A child presenting with ODD symptoms should have a comprehensive evaluation.  </li></...
What Is Bullying? Bullying in its truest form is comprised of a series of repeated intentionally cruel incidents, involvin...
“ The scars of being bullied last a life time”
Kinds of Bullies Physical Bullies Verbal Bullies Relational Bullies Reactive Bullies
By age 24, up to sixty percent of people who are identified as childhood bullies have at least one criminal conviction. A ...
<ul><ul><li>bullying occurs once every seven minutes  </li></ul></ul><ul><ul><li>on average, bullying episodes are brief, ...
Most Children with ODD have an ADHD component
ADHD <ul><li>“ That energy which makes the child hard to manage, is the energy, which makes him a manager of life.” </li><...
Characteristics of ADHD <ul><li>Inattentive Type </li></ul><ul><li>spacey, mild anxiety, socially withdrawn,  </li></ul><u...
CONDUCT DISORDER AND EMOTIONAL IMPAIRMENT
WHAT IS EI? What is Social Maladjustment or Behavioral Disturbance?..and where does Conduct Disorder fit in?  <ul><li>Emot...
Social Maladjustment; Conduct Disorder
Social Maladjustment and Emotional Impairment are two distinct behavioral disorders.
According to educational guidelines, students with social maladjustment are not truly disabled. (This however, does not me...
Students with conduct disorder engage in deliberate acts of self-interest to gain attention or to intimidate others.  They...
Conduct Disorder is best understood as a distinctive pattern of antisocial behavior that violates the rights of others. In...
<ul><li>Maladjusted/Conduct Disorder students: </li></ul><ul><li>perceive themselves as normal </li></ul><ul><li>are capab...
<ul><li>DSM-IV Criteria for Conduct Disorder: </li></ul><ul><ul><li>Aggression -bullies, threatens others, fights, uses a ...
Social Maladjustment/Conduct Disorder; In Search of a Heart <ul><li>Lack of a conscience </li></ul><ul><li>Lack of empathy...
Co-Morbidity and C.D. <ul><li>A proportion of individuals with ODD later develop CD, and a proportion of those with CD wil...
The comorbidity rate for CD and ADHD in the community population is 23 %. The comorbidity rate for CD and major depression...
Students with Emotional Impairment engage in  involuntary  patterns of behavior and experience  internalized distress  abo...
SOMETIMES THEY JUST  REALLY  CAN NOT HELP IT!  It is hard to pick a direction….
What is Michigan’s Criteria for an Emotional Impairment? <ul><li>Emotional Impairment shall be determined through manifest...
Emotional Impairment MET Form Continued <ul><li>The problem result in behaviors manifested by 1 or more </li></ul><ul><li>...
<ul><li>Emotional Impairment also includes students who, in addition to the characteristics specified above, exhibit malad...
<ul><li>The term “Emotional Impairment” does not include persons who are socially maladjusted, unless it is determined tha...
It is possible for a student to exhibit behaviors characteristic of both disorders and then certified appropriately as Emo...
<ul><li>Educational options for Emotionally Impaired and Socially Maladjusted students often parallel.   </li></ul><ul><li...
For the child with an Emotional Impairment, diffusing a crisis will often involve reducing anxiety.  For the child with Co...
<ul><li>Emotional Impairment does not include students whose behaviors are primarily the result of intellectual, sensory, ...
Internal vs. External Behaviors  <ul><li>Disorders viewed as internalizing: Affective disorders, Elective Mutism, Separati...
<ul><li>IT IS NOT UNCOMMON THAT A MENTAL HEALTH DISORDER GETS MISSED </li></ul><ul><li>Major Depression:  ¼ to ½ of childr...
Things that you already know that will help with EI and CD students: <ul><li>Daily Schedule </li></ul><ul><li>Transition T...
The ODD and CD Child <ul><li>We take them home with us every day. </li></ul><ul><li>Our family knows them without ever hav...
Our most challenging children <ul><li>May not respond to traditional consequences </li></ul><ul><li>Will require more supp...
To Reach the 1-7%  <ul><li>Abandon ineffective practices. Resist inclination to exclude. </li></ul><ul><li>Separate what t...
 
Problems with Punishment <ul><li>Punishment focuses on external control </li></ul><ul><li>but does little to teach interna...
Best Practice Interventions   To be covered this afternoon <ul><li>General Treatment of ODD </li></ul><ul><li>Ross Green’s...
Finding the Heart: Breaking Down the Walls <ul><li>Can we teach the CD, RAD child to care? </li></ul><ul><li>Building a co...
Supportive Interventions for the child with RAD <ul><li>Proximity is essential </li></ul><ul><li>Consistency and Stability...
General Approach Strategies for the RAD,ODD,CD Child <ul><li>Avoid Ultimatums </li></ul><ul><li>Avoid drawing the line in ...
Recommended General Strategies for the RAD,ODD, CD child <ul><li>Provide choices </li></ul><ul><li>Provide adequate respon...
SEARCH FOR THEIR TALENTS
BUILDING RELATIONSHIPS The Hidden Variable
Protective Factors <ul><li>Attributes or assets than when present protect the child from developing harmful, destructive, ...
External Protective Factors <ul><li>Care and Support </li></ul><ul><li>a. close bonds </li></ul><ul><li>b. positive role m...
Internal Protective Factors <ul><li>Social Skills </li></ul><ul><li>Problem Solving Skills </li></ul><ul><li>Self-Control ...
Building Community is About Relationships <ul><li>What is a true friend? </li></ul><ul><li>Developing the rules </li></ul>...
Ross Greene’s  Three Basket Method <ul><li>Three goals with this method: </li></ul><ul><li>1. To maintain adults as author...
Three basket method: How it works <ul><li>Behaviors are divided into three baskets. </li></ul><ul><ul><li>Basket A -are no...
Advantages of this Treatment Approach <ul><li>Breaks behaviors down into three approachable categories. </li></ul><ul><li>...
Limitations of the 3-basket method <ul><li>It is ideal to make this work that all parties; teachers, parents, support staf...
Life-Spaced Crisis Intervention Presented by Lisa Cobb
Life-Spaced Crisis Intervention <ul><li>The needs of the troubled and troubling youth we serve today are greater than ever...
<ul><li>LSCI is a time-tested technique for helping troubled and troubling children and youth who are in crisis in their h...
<ul><li>Most staff working with troubled and troubling children and youth have the </li></ul><ul><li>heart and the experie...
<ul><li>Training in LSCI is a five-day intensive experience. Participants will view video taped sequences of actual crisis...
<ul><li>This intervention is based on twenty-seven specific skills needed to respond successfully to a student's crisis.  ...
These concepts are anchored in supporting, caring relationships  between the student and the staff.
<ul><li>There are three possible outcomes of crisis: </li></ul><ul><li>Staff student  relationship  is improved  </li></ul...
<ul><li>How To Use Life Space Interviewing </li></ul><ul><li>1.   Intervene.   </li></ul><ul><li>2.   Listen to the involv...
<ul><li>There are five different types of  emotional first aid . Which one you use will depend upon the situation encounte...
<ul><li>1. Reality Rub  </li></ul><ul><li>The teacher helps the student to realize that s/he has misinterpreted or refused...
<ul><li>2.  Value Repair and Restoration  </li></ul><ul><li>The teacher attempts to awaken dormant values such as respect,...
<ul><li>3.  Symptom Estrangement  </li></ul><ul><li>Some students don't realize that their behavior is inappropriate or bi...
<ul><li>4.  New Tool Salesmanship  </li></ul><ul><li>In this interview, the student is helped to improve his/her ability t...
<ul><li>5.  Manipulation of the Boundaries of the Self  </li></ul><ul><li>This interview is used with two types of student...
Individual Positive Behavior Supports and Functional Assessment
“ If you know why, you can figure out how….” W. Edward Deming
 
Functional Assessment or Investigating the Behavior <ul><li>Just like the name: </li></ul><ul><li>An opportunity to assess...
Functional Assessment or Investigating the Behavior <ul><li>Your opportunity to play Columbo </li></ul><ul><ul><li>Ask que...
“ Just the facts, mam.”
Individual Child Behavior <ul><li>Functional Assessment (FA) </li></ul><ul><li>Behavior Intervention Plan (BIP) </li></ul>
 
The Function of RAD,ODD, and CD Behaviors
Needs <ul><li>Attention  </li></ul><ul><li>Escape/Avoidance </li></ul><ul><li>Power and Control Seeking </li></ul><ul><li>...
Behavior Plan <ul><li>Proactive Strategies </li></ul><ul><li>Reinforcement Strategies </li></ul><ul><li>Reactive Strategie...
Reinforcement Strategies <ul><li>Verbal </li></ul><ul><li>Proximity/Attention </li></ul><ul><li>Social </li></ul><ul><li>M...
Consequences <ul><li>Decrease the efficiency of the target behavior while maintaining dignity and an atmosphere of caring ...
 
Positive Behavioral Supports & Balanced & Restorative Justice “P roviding Consequences that  Teach and Restore”
Typical reactive responses <ul><li>Zero tolerance policies </li></ul><ul><li>Security guards, student uniforms, metal dete...
Parallels to School-based and Community-based Retributive Justice
Balanced and Restorative Justice (BARJ)
View behavioral errors as opportunities to teach <ul><li>Consequences that restore </li></ul><ul><li>Consequences that tea...
What is BARJ? <ul><li>Philosophy  </li></ul><ul><li>Repair the harm </li></ul><ul><li>Victim, Offender, Community </li></u...
Restoration teaches self control   through modeling, mediation, and   community restoration Punishment teaches external co...
Behavioral offences are wounds… Consequences should heal
Restorative Justice in School Communities <ul><li>Traditional </li></ul><ul><li>Misconduct defined as breaking the rules <...
References and other Resources to Consider <ul><li>Nurtured Heart Approach - Howard Glasser </li></ul><ul><li>Discipline, ...
Question and Answer Time <ul><li>Wendy, Lisa, and Steve  </li></ul>
Evaluations
“ If you treat an individual as he is, he will stay as he is, but if you treat him as if he were what he ought to be and c...
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Steve Vitto Breaking Down The Walls With Attachment, Social Maladjustment And Oppositional Defiance Disorder

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A presentation that reviews the recent findings on the importance of a healthy attachment, the emergence of social maladjustment and conduct disorder, distinguishing conduct disorder and emotional disturbance, comorbidity and ADHD

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  • Steve Vitto Breaking Down The Walls With Attachment, Social Maladjustment And Oppositional Defiance Disorder

    1. 1. BREAKING DOWN THE WALLS: REACHING THE DEFIANT CHILD
    2. 2. Without love or caring in a child’s life, a disconnected hollow shell is likely to evolve- a living cavity without conscience, values, or character. The lost heart begins to construct a wall one brick at a time. While waiting for someone to care, someone to reach out, someone to make a difference, the wall gets bigger and bigger. The lost heart begins to use the wall to shield it from the pain of rejection and failure. It becomes easier to attack and alienate, to blame and defend, than to risk the pain of not feeling as though you have something special, something others would value, something others would care about. And if we miss the window of opportunity to nourish this hungry heart before the wall is completed, we only have to look to the streets or to our prisons, collection grounds for empty hearts who were never fully nourished, to see what the absence of this emotion can do to a child. So, before we talk about kids needing to be intrinsically motivated or “just do the right thing for the sake of doing the right thing,” we need to recognize that we might be mistaken when we assume we can walk in a child’s shoes or view the world through his eyes. Every child needs to feel that he has value, that he is cared for, that he is loved. Today we hope we will start you on your journey to “breaking down the walls.” Breaking Down the Walls From “In Search of a Heart”
    3. 3. ATTACHMENT DISORDER OPPOSITIONAL DEFIANCE DISORDER CONDUCT DISORDER ATTENTION DEFICIT HYPERACTIVITY DISORDER EMOTIONAL IMPAIRMENT ANXIETY DISORDERS FETAL ALCOHOL SYNDROME ASPERGERS SYNDROME Conditions Effecting Behavior
    4. 4. THE NATURE OF ATTACHMENT Presented by Steven Vitto
    5. 5. <ul><li>The National Adoption Center reports that 52% of adoptable children have attachment related atypical behavioral symptoms </li></ul><ul><li>Eighty percent of maltreated infants also have attachment related behavioral symptoms </li></ul><ul><li>Sixty to eighty percent of children who have spent time in foster care show marked symptoms </li></ul><ul><li>It is estimated that over half of all incarcerated adults suffer from of psychopathology caused by breaks in childhood attachment </li></ul>
    6. 6. “ AN ATTACHMENT FORMS BETWEEN INFANT AND PRIMARY CAREGIVER SOMETIME DURING THE INFANT’S FIRST TWO YEARS OF LIFE.”
    7. 7. Attachment is the “lasting psychological connectedness between human beings.”
    8. 8. “ The quality of our attachment acts as a foundation for our future.”
    9. 9. The Basic Function of Secure Attachment <ul><li>Learn basic trust and reciprocity. </li></ul><ul><li>Explore the environment with feelings of safety and security which leads to healthy cognitive and social development. </li></ul><ul><li>Develop the ability to self-regulate, which results in effective management of impulses and emotions. </li></ul><ul><li>Create a foundation for the formation of identity. </li></ul><ul><li>Establish a prosocial moral framework, which involves empathy. </li></ul><ul><li>Generate the core belief system. </li></ul><ul><li>Provides a defense against stress and trauma. </li></ul>
    10. 10. “ AN ATTACHMENT DISORDER OCCURS WHEN THE ATTACHMENT PERIOD IS DISRUPTED OR INADEQUATE, LEAVING THE CHILD WITH THE INABILITY TO FORM A NORMAL RELATIONSHIP WITH OTHERS AND CAUSING AN IMPAIRMENT IN DEVELOPMENT.”
    11. 11. Risk Factors for Developing Attachment Disorders. <ul><li>Maternal ambivalence towards pregnancy. </li></ul><ul><li>Sudden separation from the primary caregiver (death of mother, hospitalization). </li></ul><ul><li>Abuse (physical emotional sexual). </li></ul><ul><li>Frequent moves and placements (foster care, failed adoptions). </li></ul>
    12. 12. Risk Factors (Continued…) <ul><li>Traumatic prenatal experience (in-utero exposure to alcohol/drugs). </li></ul><ul><li>neglect or parental ambivalence. </li></ul><ul><li>Genetic predisposition. </li></ul><ul><li>Birth trauma. </li></ul><ul><li>Undiagnosed and/or painful illness or injury. </li></ul><ul><li>Inconsistent or inadequate day care. </li></ul><ul><li>Unprepared mothers with poor parenting skills. </li></ul>
    13. 13. DSM-IV RAD DEFINITION <ul><li>A markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age five, as evidenced by either: </li></ul><ul><li>Inhibited Type </li></ul><ul><li>(failure to initiate or respond in a developmental appropriate fashion-excessively ambivalent, hyper vigilant, excessively inhibited, resistant to comforting, avoidance) </li></ul><ul><li>Disinhibited Type </li></ul><ul><li>(diffuse attachment manifested by indiscriminate sociability (e.g. excessive familiarity with relative strangers or lack of selectability with attachment figure </li></ul>
    14. 14. Characteristics or Symptoms of Attachment Disorder: <ul><li>Superficially charming: uses cuteness to get her or his way. </li></ul><ul><li>Cruel to animals or people. </li></ul><ul><li>Fascinated by fire/death/blood/gore. </li></ul><ul><li>Severe need for control over adults even over minute situations. </li></ul><ul><li>Manipulative-plays adults against each other. </li></ul><ul><li>Difficulty in making eye-contact. </li></ul><ul><li>Lack of affection on parental terms yet overly affectionate to strangers. </li></ul><ul><li>Bossy. </li></ul><ul><li>Shows no remorse---seems to have no conscience. </li></ul><ul><li>Lies and steals. </li></ul><ul><li>Low impulse control. </li></ul><ul><li>Lack of cause/effect thinking. </li></ul><ul><li>Destructiveness to self, others and material things. </li></ul>
    15. 15. <ul><li>Has difficulty making and keeping friends. </li></ul><ul><li>Speech and language problems. </li></ul><ul><li>Overall developmental delay. </li></ul><ul><li>Demanding/clingy. </li></ul><ul><li>Incessant chattering/ Non-stop question asking. </li></ul><ul><li>Hoards/Sneaks/ Stuffs food. </li></ul><ul><li>Emotions don’t match the situation and </li></ul><ul><li>are unpredictable. </li></ul><ul><li>Overly sensitive to sights/sounds/touch/smells. </li></ul><ul><li>Exhibits hyperactivity. </li></ul><ul><li>Exhibits impulsivity. </li></ul><ul><li>Disregulated eating/sleeping/toileting patterns. </li></ul>ATTACHMENT DISORDER CHARACTERISTICS (CONTINUED)
    16. 16. Diagnosing Attachment Disorder
    17. 17. Attachment Checklists <ul><li>Three types of Adult/child self-report </li></ul><ul><ul><li>Parents record child’s behavior. </li></ul></ul><ul><ul><li>Refers to adult functioning. </li></ul></ul><ul><ul><li>Checklists and observational inventories used by assessing professionals. </li></ul></ul><ul><ul><li>Early history is key component in determining an attachment problem. </li></ul></ul>
    18. 18. Compromised Brain Development <ul><li>Ross Green (The Explosive Child) suggests that there is compelling evidence to suggest that irregularities in the prefrontal and frontal regions may contribute to the impairments of “excutive thinking skills.” </li></ul><ul><li>“ The child’s explosive behavior may be unplanned and unintentional and reflect a physiologically based developmental delay in the skills of flexibility and frustration tolerance.” </li></ul><ul><li>Schore believes that early life stressful experiences may permanently damage the orbital frontal cortex. The frontal cortex is clearly involved in socialized behavior. </li></ul><ul><li>Part of the problems with impulse control and noncompliance may be due to damage in the orbital frontal cortex. </li></ul>
    19. 19. DIAGNOSIS??? It is important to remember that a diagnosis is not a scientific fact. It is a considered opinion based upon the behavior of the child over time, what is known of the child's family history, the child's response to medications, his or her developmental stage, the current state of scientific knowledge and the training and experience of the doctor making the diagnosis.
    20. 20. Prognosis: <ul><li>Eighty percent of children with Oppositional Defiance Disorder showed insecure attachment. </li></ul><ul><li>Insecurely attached children often grow up to become insecurely attached parents, and the cycle continues </li></ul>
    21. 21. What the research says about overcoming the effects of insecure or interrupted attachment. <ul><li>Prognosis is Tenuous </li></ul><ul><li>High Risk for Interpersonal Problems </li></ul><ul><li>High Risk for Not Responding to Traditional Behavioral Treatment Approaches </li></ul><ul><li>High Risk for Oppositional Defiance </li></ul><ul><li>Disorder </li></ul><ul><li>High Risk for Conduct Disorder </li></ul><ul><li>Age of Intervention is a significant variable </li></ul><ul><li>Most Frequently Identified Protective Factors include: Intelligence, Proximity, and Constancy </li></ul>
    22. 22. OPPOSITIONAL DEFIANCE DISORDER
    23. 23. All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family, and academic life.
    24. 24. What is Oppositional Defiance Disorder? ODD is a persistent pattern (lasting for at least six months) of negativistic, hostile, disobedient, and defiant behavior in a child or teen without serious violation of the basic rights of others.
    25. 25. ODD DEFINED <ul><li>The key distinction from other types </li></ul><ul><li>of conduct disorder is the absence </li></ul><ul><li>of behavior that violates the law </li></ul><ul><li>and the basic rights of others, such </li></ul><ul><li>as theft, cruelty, bullying, assault, </li></ul><ul><li>and destructiveness </li></ul>
    26. 26. Oppositional Defiance Disorder <ul><li>ODD is a nondelinquent conduct disorder </li></ul><ul><li>ODD occurs in about 6% of children </li></ul><ul><li>ODD is more common to boys prior to </li></ul><ul><li>puberty </li></ul><ul><li>ODD is equal in both sexes after puberty </li></ul>
    27. 27. What are the Symptoms of Oppositional Defiance Disorder? <ul><li>Frequent loss of temper; </li></ul><ul><li>Arguing with adults </li></ul><ul><li>Defying adults </li></ul><ul><li>Refusing adult requests or rules </li></ul><ul><li>Deliberately annoying others </li></ul><ul><li>Blaming others for mistakes and misbehavior </li></ul>
    28. 28. Oppositional Defiance Disorder <ul><li>Being touchy or easily annoyed </li></ul><ul><li>Being angry and resentful </li></ul><ul><li>Being spiteful or vindictive </li></ul><ul><li>Swearing or using obscene language </li></ul><ul><li>Have a low opinion of themselves </li></ul><ul><li>Moody and easily frustrated </li></ul>
    29. 29. It is important to distinguish between a won’t problem and a can’t problem <ul><li>Can be difficult to assess </li></ul><ul><li>Treating a can’t problem with punishment can cause distrust and alienation </li></ul><ul><li>Treating a won’t problem with punishment and reward programs can result in deceit and manipulation </li></ul>
    30. 30. Contra-Indicated Behavioral Strategies for the ODD Child <ul><li>Ultimatums </li></ul><ul><li>Strict Boundaries: Drawing the Line in the Sand </li></ul><ul><li>Counts, Warnings, Threats </li></ul><ul><li>Prolonged Eye-Contact </li></ul><ul><li>Infringing on Personal Space </li></ul><ul><li>Social Disapproval </li></ul><ul><li>Judgmental Responses </li></ul><ul><li>Response Cost and Punishment </li></ul><ul><li>Strict Boundaries or Contracts </li></ul><ul><li>Suspension and Detention, Progressive Discipline </li></ul>
    31. 31. What Causes Oppositional Defiance Disorder? <ul><li>The cause of Oppositional Defiant Disorder is unknown at </li></ul><ul><li>this time. The following are some of the theories being </li></ul><ul><li>investigated: </li></ul><ul><li>It may be related to the child's temperament and the family's response to that temperament. </li></ul><ul><li>A predisposition to ODD is inherited in some families. </li></ul><ul><li>There may be problems in the brain that cause ODD. </li></ul><ul><li>It may be caused by a chemical imbalance in the brain. </li></ul><ul><li>Children with ODD have often experienced a break in </li></ul><ul><li>attachment or bonding during the first 2 years of life </li></ul>
    32. 32. Contributing Factors <ul><li>Parents and teachers who impose inconsistent ---harsh punishment mixed with lax, inconsistent rules, neglect, and irrational authority will exacerbate temperamental difficulties with the child. </li></ul><ul><li>Temperamental difficulties of the child may include intense affect, withdrawal from novelty, poor self-control, slow adaptation to change, irregular sleep and wake cycles, easily distractibility, etc. </li></ul>
    33. 33. Russell Barkley’s 4-Factor Method: Etiology of ODD <ul><li>Factor 1: </li></ul><ul><li>The child’s or teen’s characteristics </li></ul><ul><li>Factor 2: </li></ul><ul><li>The parent’s characteristics </li></ul><ul><li>Factor 3: </li></ul><ul><li>The family environment and stress </li></ul><ul><li>Factor 4: </li></ul><ul><li>Parenting Style </li></ul>
    34. 34. Factor #1: The child or teen’s characteristics-Temperament <ul><li>Temperament is behavioral style ; it is the characteristic way an individual child exper-iences and responds to internal and external stimuli. </li></ul><ul><li>The concept of temperament leads to a view of children as unique individuals, each with his or her own particular vulnerabilities, strengths, and coping mechanisms. </li></ul>
    35. 35. Responding to Temperament <ul><li>Expert parenting or teaching not seen as acting according to a set of general rules. </li></ul><ul><li>Expert teaching and/or parenting is considered to be founded on a loving, yet objective, understanding of a particular child. </li></ul><ul><li>Guidelines for education, scheduling, communication, discipline, and other management strategies vary according to the temperament of the child. </li></ul>
    36. 36. Temperament <ul><li>Largely determined by genetic factors. </li></ul><ul><li>Shows considerable stability over time. </li></ul><ul><li>Can be modified by–but not transformed—by environmental influences . </li></ul><ul><li>Early 1960’s, Thomas and Chess (New York City) started to publish articles about temperament; described nine traits that contribute to temperament--- </li></ul>
    37. 37. Nine traits that Contribute to Temperament <ul><li>1. ACTIVITY: the amount of physical motion during sleep, eating, play, dressing, bathing, and so forth. </li></ul><ul><li>2. RHYTHMICITY: the regularity of physio-logic functions such as hunger, sleep, and elimination. </li></ul><ul><li>3. APPROACH/WITHDRAWAL: the nature of initial responses to new stimuli--people, situations, places, foods, toys, procedures. </li></ul>
    38. 38. Temperamental Traits <ul><li>4. ADAPTABILITY: the ease or difficulty with which reactions to stimuli can be mod-ified in a desired way. </li></ul><ul><li>5. INTENSITY: the energy level of responses regardless of quality or direction. </li></ul><ul><li>6. MOOD: the amount of pleasant and friendly, or unpleasant and unfriendly, behavior in various situations. </li></ul>
    39. 39. Temperamental Traits <ul><li>7. PERSISTENCE AND ATTENTION SPAN: the length of time particular activities are pursued by the child, with or without obstacles. </li></ul><ul><li>8. DISTRACTIBILITY: the effectiveness of extraneous environmental stimuli in inter-fering with ongoing behaviors. </li></ul><ul><li>9. SENSORY THRESHOLD: the amount of stimulation, such as sounds or light, necessary to evoke discernible responses in the child. </li></ul>
    40. 40. Child Unhappy at Her Own Birthday Party
    41. 41. Why was this little girl’s party a failure? Overlooking Temperament <ul><li>High intensity (expresses emotions in a strong way, including her present unhap-piness). </li></ul><ul><li>Low sensory threshold (uncomfortable in her starched dress, very aware of its scratchiness). </li></ul><ul><li>Initial withdrawal (her usual first impulse is to withdraw from new things, and this was a surprise party). </li></ul>
    42. 42. Temperamental Traits of This Particular Child <ul><li>Poor adaptability (has trouble with transition and change of routine). </li></ul><ul><li>Negative mood (doesn’t show pleasure openly, not a “sunny” disposition). </li></ul><ul><li>Parents are very disappointed the child did not enjoy her birthday party, and don’t understand why it was not fun for her; they ask her pediatrician’s advice regarding plans for next year’s party. </li></ul>
    43. 43. Factor 2 The Parent’s Characteristics <ul><li>Physical and temperamental characteristics </li></ul><ul><li>Psychiatric disorders </li></ul><ul><li>Marital problems </li></ul><ul><li>Predisposition </li></ul><ul><li>Inadvertent Contributions to ODD </li></ul>
    44. 44. Factor 3 The Family’s Environment and Family Stress <ul><li>Economic Status </li></ul><ul><li>Housing </li></ul><ul><li>Jobs </li></ul><ul><li>Marital Status </li></ul><ul><li>Stressful Environmental Conditions </li></ul>
    45. 45. Factor 4 Parenting/Teaching Style <ul><li>Inconsistent consequences </li></ul><ul><li>Lack of positive attention or reinforcement to prosocial or appropriate child and teen behaviors </li></ul><ul><li>Poor monitoring of child or teen </li></ul><ul><li>Punishment of prosocial or appropriate behaviors </li></ul><ul><li>Extreme attitudes and beliefs </li></ul><ul><li>Basic Coercive Interchange </li></ul>
    46. 46. Our Need for Power and Control
    47. 47. Underlying Systems of Control in School <ul><li>The use of reinforcement </li></ul><ul><li>Response Cost-loss of privileges, loss of points, loss of access to reinforcing events, etc. </li></ul><ul><li>Restrictive classroom rules and boundaries-e.g., “ No going in my desk.” </li></ul><ul><li>“ No going into this area.” </li></ul><ul><li>“ No talking while in line.” </li></ul><ul><li>“ Sitting with both both feet on the floor.” </li></ul><ul><li>“ Raising your hand before talking.” </li></ul><ul><li>Expecting immediate compliance </li></ul><ul><li>Suspension, Detention, and other forms of punishment </li></ul>
    48. 48. How should ODD be evaluated? <ul><li>A child presenting with ODD symptoms should have a comprehensive evaluation. </li></ul><ul><li>It is important to look for other disorders which may be present; such as, attention-deficit hyperactive disorder (ADHD), learning disabilities, emotional disturbances-I.e.,mood disorders (depression, bipolar disorder) and anxiety disorders. </li></ul><ul><li>It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. </li></ul><ul><li>Some children with ODD may go on to develop called conduct disorder. </li></ul>
    49. 49. What Is Bullying? Bullying in its truest form is comprised of a series of repeated intentionally cruel incidents, involving the same children, in the same bully and victim roles.
    50. 50. “ The scars of being bullied last a life time”
    51. 51. Kinds of Bullies Physical Bullies Verbal Bullies Relational Bullies Reactive Bullies
    52. 52. By age 24, up to sixty percent of people who are identified as childhood bullies have at least one criminal conviction. A study spanning 35 years by psychologist E. Eron at the University of Michigan found that children who were named by their school mates, at age eight, as the bullies of the school were often bullies throughout their lives
    53. 53. <ul><ul><li>bullying occurs once every seven minutes </li></ul></ul><ul><ul><li>on average, bullying episodes are brief, approximately 37 seconds long </li></ul></ul><ul><ul><li>the emotional scars from bullying can last a lifetime </li></ul></ul><ul><ul><li>the majority of bullying occurs in or close to school buildings </li></ul></ul><ul><ul><li>most victims are unlikely to report bullying </li></ul></ul><ul><ul><li>only 25% of students report that teachers intervene in bullying situations, while 71% of teachers believe they always intervene </li></ul></ul><ul><ul><li>situations, therefore bullying is often overlooked </li></ul></ul>RESEARCH ON BULLYING
    54. 54. Most Children with ODD have an ADHD component
    55. 55. ADHD <ul><li>“ That energy which makes the child hard to manage, is the energy, which makes him a manager of life.” </li></ul><ul><li>“ Just when I thought about not doing something, I already did it.” </li></ul><ul><li>Logo seen on T-shirt for ADHD adult </li></ul><ul><li>“ They say I have ADHD, did you see that </li></ul><ul><li>chicken go by?” </li></ul>
    56. 56. Characteristics of ADHD <ul><li>Inattentive Type </li></ul><ul><li>spacey, mild anxiety, socially withdrawn, </li></ul><ul><li>day dreamers, difficulty sustaining attention, </li></ul><ul><li>difficulty listening, often leaves school work unfinished,difficulty with organization, problems with sustained mental effort, forgetful,distractible </li></ul><ul><li>Hyperactive Impulsive Type </li></ul><ul><li>fidgets,squirms,impulse control difficulties, </li></ul><ul><li>excessive talking or blurting out, out of seat, difficulty playing quietly, always moving, difficulty waiting turn </li></ul>
    57. 57. CONDUCT DISORDER AND EMOTIONAL IMPAIRMENT
    58. 58. WHAT IS EI? What is Social Maladjustment or Behavioral Disturbance?..and where does Conduct Disorder fit in? <ul><li>Emotional Impairment is terminology used in the educational setting in conjunction with Behavioral Disturbance which is language used in IDEA. </li></ul><ul><li>Social maladjustment is conceptualized as a conduct problem. </li></ul><ul><li>Social maladjustment tends to be an educational term which is frequently interchanged with the term Conduct Disorder in DSM IV. </li></ul>
    59. 59. Social Maladjustment; Conduct Disorder
    60. 60. Social Maladjustment and Emotional Impairment are two distinct behavioral disorders.
    61. 61. According to educational guidelines, students with social maladjustment are not truly disabled. (This however, does not mean that they do not have needs!)
    62. 62. Students with conduct disorder engage in deliberate acts of self-interest to gain attention or to intimidate others. They experience no distress or self-devaluation or internalized distress.
    63. 63. Conduct Disorder is best understood as a distinctive pattern of antisocial behavior that violates the rights of others. Individuals with conduct disorder break rules/violate norms across settings. Conduct Disorder
    64. 64. <ul><li>Maladjusted/Conduct Disorder students: </li></ul><ul><li>perceive themselves as normal </li></ul><ul><li>are capable of behaving appropriately </li></ul><ul><li>choose to break rules and violate norms. </li></ul><ul><li>view rule breaking as normal and acceptable. </li></ul><ul><li>are motivated by self-gain and strong survival skills </li></ul><ul><li>lack age appropriate concern for their behavior </li></ul><ul><li>displayed behavior which may be highly valued in a small subgroup </li></ul><ul><li>display socialized or unsocialized forms of aggression </li></ul><ul><li>due not display anxiety unless they fear being caught </li></ul><ul><li>intensity and duration of behavior differs markedly </li></ul><ul><li>from peer group </li></ul>
    65. 65. <ul><li>DSM-IV Criteria for Conduct Disorder: </li></ul><ul><ul><li>Aggression -bullies, threatens others, fights, uses a weapon, cruel to people/animals, forced sexual activity </li></ul></ul><ul><ul><li>Destruction of property -fire setting, destroyed others' property </li></ul></ul><ul><ul><li>Deceitfulness or theft -broken into houses/cars/buildings, often lies or cons others, has stolen without victim present </li></ul></ul><ul><ul><li>Serious rule violations -often stays out at night without permission, has run away, is often truant. </li></ul></ul><ul><li>(DSM -IV, 1994) </li></ul>
    66. 66. Social Maladjustment/Conduct Disorder; In Search of a Heart <ul><li>Lack of a conscience </li></ul><ul><li>Lack of empathy </li></ul><ul><li>Failure to take responsibility for behavior </li></ul><ul><li>Intentional in rule violation and norms </li></ul>
    67. 67. Co-Morbidity and C.D. <ul><li>A proportion of individuals with ODD later develop CD, and a proportion of those with CD will later develop ASPD (Loeber, Burke, Lahey, & Zera, 2000). </li></ul><ul><li>  Studies researching the co-morbid associations with CD have found significant co-morbid relationships between CD and learning disorders, anxiety disorders, mood disorders, and substance related disorders. </li></ul>
    68. 68. The comorbidity rate for CD and ADHD in the community population is 23 %. The comorbidity rate for CD and major depression in the community population is 17 %. The comorbidity rate for CD and anxiety disorders in the community population is 15 % (Carr, 2000).
    69. 69. Students with Emotional Impairment engage in involuntary patterns of behavior and experience internalized distress about their behaviors.
    70. 70. SOMETIMES THEY JUST REALLY CAN NOT HELP IT! It is hard to pick a direction….
    71. 71. What is Michigan’s Criteria for an Emotional Impairment? <ul><li>Emotional Impairment shall be determined through manifestation of behavioral problems primarily in the affective domain, over an extended period of time, which adversely affect the student’s education to the extent that the student can not profit from learning experiences without special education support. </li></ul>
    72. 72. Emotional Impairment MET Form Continued <ul><li>The problem result in behaviors manifested by 1 or more </li></ul><ul><li>of the following: </li></ul><ul><li>(A) An inability to build or maintain satisfactory interpersonal relationships with peers and teachers. </li></ul><ul><li>(B) Inappropriate types of behavior or feelings under normal circumstances. </li></ul><ul><li>(C) A general pervasive mood of unhappiness or depression. </li></ul><ul><li>(D) A tendency to develop physical symptoms or fears associated with personal or school problems. </li></ul>
    73. 73. <ul><li>Emotional Impairment also includes students who, in addition to the characteristics specified above, exhibit maladaptive behaviors related to schizophrenia or similar disorders. </li></ul>
    74. 74. <ul><li>The term “Emotional Impairment” does not include persons who are socially maladjusted, unless it is determined that the persons have an Emotional Impairment. </li></ul>
    75. 75. It is possible for a student to exhibit behaviors characteristic of both disorders and then certified appropriately as Emotionally Impaired. A thorough, objective evaluation is the key to an appropriate outcome.
    76. 76. <ul><li>Educational options for Emotionally Impaired and Socially Maladjusted students often parallel. </li></ul><ul><li>Small class size, individualized programming, modified curriculum. </li></ul><ul><li>Work study, adjusted school hours, vocational programming, shorten academic periods and alternative placement. </li></ul>
    77. 77. For the child with an Emotional Impairment, diffusing a crisis will often involve reducing anxiety. For the child with Conduct Disorder and effective response should increase anxiety
    78. 78. <ul><li>Emotional Impairment does not include students whose behaviors are primarily the result of intellectual, sensory, or health factors. </li></ul>
    79. 79. Internal vs. External Behaviors <ul><li>Disorders viewed as internalizing: Affective disorders, Elective Mutism, Separation Anxiety Disorder may qualify as Emotional Impairment </li></ul><ul><li>Disorders viewed as externalizing: Conduct Disorder, Oppositional Defiant Disorder or Anti-Social Personality Disorder, may indicated Social Maladjustment </li></ul><ul><li>Differential Diagnosis is important to determine if the external behavior may look the same, but the underlying reasons, etiology and intent, may be different. </li></ul>
    80. 80. <ul><li>IT IS NOT UNCOMMON THAT A MENTAL HEALTH DISORDER GETS MISSED </li></ul><ul><li>Major Depression: ¼ to ½ of children with CD have either anxiety disorder or depression </li></ul><ul><li>Bipolar Disorder: </li></ul><ul><li>Anxiety Disorder: </li></ul><ul><li>Reactive Attachment Disorder </li></ul><ul><li>Tourette’s Syndrome </li></ul><ul><li>Personality Disorder </li></ul><ul><li>Eating Disorders: </li></ul><ul><li>Attention Deficit Hyperactivity Disorder: </li></ul><ul><li>Substance Abuse: </li></ul>
    81. 81. Things that you already know that will help with EI and CD students: <ul><li>Daily Schedule </li></ul><ul><li>Transition Time </li></ul><ul><li>Consistent Assignment Format </li></ul><ul><li>Positive Behavior Support </li></ul><ul><li>Teacher/Student Contact </li></ul><ul><li>Functional Behavioral Assessment </li></ul><ul><li>Behavior Intervention Plan </li></ul>
    82. 82. The ODD and CD Child <ul><li>We take them home with us every day. </li></ul><ul><li>Our family knows them without ever having met them. </li></ul><ul><li>We dream about them. </li></ul><ul><li>They learn how to push our buttons. </li></ul><ul><li>They can take us down a road we don’t want to travel. </li></ul><ul><li>They make us think that maybe we should have gone into marketing or real estate. </li></ul><ul><li>They are extremely difficult to like at times… </li></ul>
    83. 83. Our most challenging children <ul><li>May not respond to traditional consequences </li></ul><ul><li>Will require more support and change on our part </li></ul><ul><li>Will need a significant positive relationship at school </li></ul><ul><li>Will need another way to find acceptance in the school environment </li></ul><ul><li>May be resistant to strategies to develop self control </li></ul>
    84. 84. To Reach the 1-7% <ul><li>Abandon ineffective practices. Resist inclination to exclude. </li></ul><ul><li>Separate what the child deserves and what he needs. </li></ul><ul><li>Realize that he/she needs our support and forgiveness the most. </li></ul><ul><li>Reframe who they are. </li></ul><ul><li>Think “outside the box.” </li></ul><ul><li>Abandon expectation of a quick fix </li></ul><ul><li>Need a 7:1 reinforcement ratio, with meaningful incentives </li></ul><ul><li>Need peer support. </li></ul><ul><li>Need to undermine harmful mentors </li></ul>
    85. 86. Problems with Punishment <ul><li>Punishment focuses on external control </li></ul><ul><li>but does little to teach internal control. </li></ul><ul><li>Punishment does not teach the child how to meet needs previously being served by the target behavior. </li></ul><ul><li>Punishment backfires with students who are oppositional and defiant. </li></ul><ul><li>Punishment often triggers an escalation of behavior and may elicit tantrums and aggression. </li></ul><ul><li>Punishment models a type of authority that resolves conflict by power and inflicting discomfort or pain. </li></ul><ul><li>Punishment is a quick term-fix that takes much less time than to teach the child betters ways of behaving. </li></ul><ul><li>Research has shown that punishment strategies have poor transferability. </li></ul><ul><li>Punishment is inconsistent with the concept of mutual respect. </li></ul><ul><li>Punishment often excludes and isolates a child when teaching and support is needed most. </li></ul>
    86. 87. Best Practice Interventions To be covered this afternoon <ul><li>General Treatment of ODD </li></ul><ul><li>Ross Green’s 3 Basket Model </li></ul><ul><li>RAD-Protective Factors and Relationship </li></ul><ul><li>Life Space Crisis Intervention </li></ul><ul><li>Positive Behavioral Supports & Functional Assessment </li></ul><ul><li>Balanced and Restorative Justice </li></ul><ul><li>Howard Glasser’s Nurtured Heart Approach </li></ul>
    87. 88. Finding the Heart: Breaking Down the Walls <ul><li>Can we teach the CD, RAD child to care? </li></ul><ul><li>Building a conscience one step at a time </li></ul><ul><li>Penetrating the wall </li></ul><ul><li>Caring for others </li></ul><ul><li>Finding their heart </li></ul><ul><li>Random acts of kindness </li></ul><ul><li>Right for the Sake of Right </li></ul>
    88. 89. Supportive Interventions for the child with RAD <ul><li>Proximity is essential </li></ul><ul><li>Consistency and Stability </li></ul><ul><li>Holding therapy </li></ul><ul><li>Applied Behavioral Analysis (Barkley) </li></ul><ul><li>Building Relationships (Bendtro) </li></ul><ul><li>Cognitive Behavioral Therapy </li></ul><ul><li>Life Space Crisis Intervention </li></ul><ul><li>Positive Behavioral Supports </li></ul><ul><li>BARJ </li></ul>
    89. 90. General Approach Strategies for the RAD,ODD,CD Child <ul><li>Avoid Ultimatums </li></ul><ul><li>Avoid drawing the line in the sand </li></ul><ul><li>Avoid social disapproval and negative reprimands </li></ul><ul><li>Avoid Warning and Counting Prompts </li></ul><ul><li>Avoid rules that challenge (“ Don’t spit on the side walk”) </li></ul><ul><li>Avoid reverse psychology </li></ul><ul><li>Avoid punishment and exclusion </li></ul><ul><li>Avoid emotional reactions </li></ul><ul><li>Avoid bullying or external control strategies </li></ul><ul><li>Avoid arbitrary or inconsistent consequences between staff </li></ul>
    90. 91. Recommended General Strategies for the RAD,ODD, CD child <ul><li>Provide choices </li></ul><ul><li>Provide adequate response time </li></ul><ul><li>Provide consistency and predictability </li></ul><ul><li>Provide a calm, neutral approach </li></ul><ul><li>Encourage ownership in development of plan </li></ul><ul><li>Provide appropriate opportunities for control </li></ul><ul><li>Work at building relationships </li></ul><ul><li>Work at breaking down the walls </li></ul><ul><li>Provide meaningful incentives </li></ul><ul><li>Provide consistent and reasonable consequences </li></ul>
    91. 92. SEARCH FOR THEIR TALENTS
    92. 93. BUILDING RELATIONSHIPS The Hidden Variable
    93. 94. Protective Factors <ul><li>Attributes or assets than when present protect the child from developing harmful, destructive, and ineffective behaviors. </li></ul>
    94. 95. External Protective Factors <ul><li>Care and Support </li></ul><ul><li>a. close bonds </li></ul><ul><li>b. positive role models </li></ul><ul><li>c. support of friends </li></ul><ul><li>Setting High Expectations </li></ul><ul><li>providing supports to achieve high expectations </li></ul><ul><li>Encouraging Meaningful Roles </li></ul><ul><li>a. valued for accomplishments </li></ul><ul><li>b. genuinely needed </li></ul><ul><li>c. given meaningful roles </li></ul>
    95. 96. Internal Protective Factors <ul><li>Social Skills </li></ul><ul><li>Problem Solving Skills </li></ul><ul><li>Self-Control </li></ul><ul><li>Self-Efficiency </li></ul><ul><li>Optimism </li></ul>
    96. 97. Building Community is About Relationships <ul><li>What is a true friend? </li></ul><ul><li>Developing the rules </li></ul><ul><li>Dignity and mutual respect </li></ul><ul><li>Consequence should teach and restore </li></ul><ul><li>What do we do when we get angry? </li></ul><ul><li>Learning how to compliment others </li></ul><ul><li>Learning how to care through modeling </li></ul>
    97. 98. Ross Greene’s Three Basket Method <ul><li>Three goals with this method: </li></ul><ul><li>1. To maintain adults as authority figures. </li></ul><ul><li>2. Teach skills of flexibility and frustration </li></ul><ul><li>tolerance. </li></ul><ul><li>3. Awareness of the child’s limitations. </li></ul>
    98. 99. Three basket method: How it works <ul><li>Behaviors are divided into three baskets. </li></ul><ul><ul><li>Basket A -are non-negotiable behaviors- usually fall into the safety and rights of others category. </li></ul></ul><ul><ul><ul><li>These behaviors are those that are important enough to endure a “meltdown” over. </li></ul></ul></ul><ul><ul><ul><li>Child must be capable of successfully exhibiting this behavior on a fairly consistent basis. </li></ul></ul></ul><ul><ul><ul><li>Basket B - These behaviors are important but can be worked on over time. They are not behaviors worth inducing a “meltdown” over. </li></ul></ul></ul><ul><ul><ul><li>Basket C - These behaviors are those that could be ignored without any significant repercussions. </li></ul></ul></ul>
    99. 100. Advantages of this Treatment Approach <ul><li>Breaks behaviors down into three approachable categories. </li></ul><ul><li>Emphasizes communication and problem solving techniques over rewards and punishments. </li></ul><ul><li>Teaches frustration tolerance. </li></ul><ul><li>Absolves blame while keeping the child’s self-esteem in tact. </li></ul>
    100. 101. Limitations of the 3-basket method <ul><li>It is ideal to make this work that all parties; teachers, parents, support staff be able to work together. </li></ul><ul><li>Dr. Greene is careful to point out that even though there are some issues that the non-medical approach addresses more effectively than the medical approach there are indeed some factors medicine addresses better than the non-medical approach. </li></ul><ul><ul><li>For those children who need medication it will make it more difficult to teach frustration tolerance when there is also an organic matter. </li></ul></ul>
    101. 102. Life-Spaced Crisis Intervention Presented by Lisa Cobb
    102. 103. Life-Spaced Crisis Intervention <ul><li>The needs of the troubled and troubling youth we serve today are greater than ever.   </li></ul><ul><li>LSCI is a multitheoretical model integrating Psychoeducational, Cognitive, Behavioral, and Pro-Social theories into a dynamic and comprehensive therapeutic strategy.   </li></ul><ul><li>It is based in the reality of the young person's immediate circumstances and the patterns that lead repeatedly lead them into crisis situations.  It is initiated by staff whom the youth know, providing excellent opportunities to build or enhance meaningful therapeutic relationships.  </li></ul><ul><li>It is clinically powerful and professionally teachable. </li></ul>
    103. 104. <ul><li>LSCI is a time-tested technique for helping troubled and troubling children and youth who are in crisis in their homes, schools, and communities. </li></ul><ul><li>Life Space Crisis Intervention is a refreshing alternative to traditional techniques and provides effective alternatives to punishment. LSCI uses crisis as an opportunity for insight and behavior change. </li></ul>
    104. 105. <ul><li>Most staff working with troubled and troubling children and youth have the </li></ul><ul><li>heart and the experience so necessary for their work. What they often lack </li></ul><ul><li>are tools: </li></ul><ul><li>Knowing what to do when a student: - refuses to accept responsibility and blames others - swears at or threatens adults - gets pleasure out of bringing pain to others - is manipulated into false friendships - engages in endless power struggles. </li></ul><ul><li>Life Space Crisis Intervention skills empower school staff to intervene </li></ul><ul><li>effectively when confronted with repetitive patterns of self-defeating </li></ul><ul><li>behavior common in troubled and troubling students. </li></ul>
    105. 106. <ul><li>Training in LSCI is a five-day intensive experience. Participants will view video taped sequences of actual crisis situations and will see the skills of LSCI effectively demonstrated and analyzed. The training includes much opportunity for skills practice through realistic role plays, activities and exercises. </li></ul>
    106. 107. <ul><li>This intervention is based on twenty-seven specific skills needed to respond successfully to a student's crisis. </li></ul>
    107. 108. These concepts are anchored in supporting, caring relationships between the student and the staff.
    108. 109. <ul><li>There are three possible outcomes of crisis: </li></ul><ul><li>Staff student relationship is improved </li></ul><ul><li>The staff student relationship is unchanged </li></ul><ul><li>The staff student relationship is damaged </li></ul>
    109. 110. <ul><li>How To Use Life Space Interviewing </li></ul><ul><li>1.  Intervene. </li></ul><ul><li>2.   Listen to the involved parties in a nonjudgmental </li></ul><ul><li>manner. </li></ul><ul><li>3.   Analyze the situation and determine whether this </li></ul><ul><li>incident is an isolated happening or part of </li></ul><ul><li>recurring theme. </li></ul><ul><li>4.   Choose a specific LSI approach. </li></ul><ul><li>5.   Implement the selected approach while being polite, </li></ul><ul><li>attentive, and concerned. </li></ul><ul><li>6.   Change or combine approaches as necessary. </li></ul>
    110. 111. <ul><li>There are five different types of emotional first aid . Which one you use will depend upon the situation encountered. </li></ul>
    111. 112. <ul><li>1. Reality Rub </li></ul><ul><li>The teacher helps the student to realize that s/he has misinterpreted or refused to recognize certain information pertinent to an incident.  The student is made aware that his or her perceptions are not correct, and s/he is informed as to the truth of the situation under discussion. </li></ul>
    112. 113. <ul><li>2.  Value Repair and Restoration </li></ul><ul><li>The teacher attempts to awaken dormant values such as respect, empathy, trust, etc.  Many students are unable, at present, to display emotions which represent vulnerability.  They tend to act out aggression, nonchalance, and anger most often.  The teacher attempts to &quot;massage&quot; the numb value areas and help develop appropriate emotional responses to certain situations. </li></ul>
    113. 114. <ul><li>3.  Symptom Estrangement </li></ul><ul><li>Some students don't realize that their behavior is inappropriate or bizarre in the eyes of others.  The teacher brings the student's attention to the specific behavior and how it is viewed by others.  It is hoped that the student will come to realize the problem and talk about other ways to meet his or her needs. </li></ul>
    114. 115. <ul><li>4.  New Tool Salesmanship </li></ul><ul><li>In this interview, the student is helped to improve his/her ability to react in a problem solving situation.  &quot;Tools&quot; or ways of solving problems are taken from past experience and applied in new situations. </li></ul>
    115. 116. <ul><li>5.  Manipulation of the Boundaries of the Self </li></ul><ul><li>This interview is used with two types of students: those who allow themselves to be &quot;used&quot; by others, and those who victimize or take advantage of others.  The student is made aware of his/her behavior pattern in an attempt to make him/her more receptive to interventions.     </li></ul>
    116. 117. Individual Positive Behavior Supports and Functional Assessment
    117. 118. “ If you know why, you can figure out how….” W. Edward Deming
    118. 120. Functional Assessment or Investigating the Behavior <ul><li>Just like the name: </li></ul><ul><li>An opportunity to assess the function of the behavior </li></ul><ul><li>Why is the behavior occurring? </li></ul><ul><li>What is the child getting because of the behavior? </li></ul><ul><li>What are environmental issues that effecting the behavior </li></ul>
    119. 121. Functional Assessment or Investigating the Behavior <ul><li>Your opportunity to play Columbo </li></ul><ul><ul><li>Ask questions </li></ul></ul><ul><ul><li>Collect as much information about the behavior as possible </li></ul></ul><ul><ul><li>Not a time for judgment – right or wrong. JUST THE FACTS </li></ul></ul><ul><ul><li>Be objective </li></ul></ul>
    120. 122. “ Just the facts, mam.”
    121. 123. Individual Child Behavior <ul><li>Functional Assessment (FA) </li></ul><ul><li>Behavior Intervention Plan (BIP) </li></ul>
    122. 125. The Function of RAD,ODD, and CD Behaviors
    123. 126. Needs <ul><li>Attention </li></ul><ul><li>Escape/Avoidance </li></ul><ul><li>Power and Control Seeking </li></ul><ul><li>Anger/Frustration </li></ul><ul><li>Sensory Stimulation </li></ul><ul><li>Tangible </li></ul>
    124. 127. Behavior Plan <ul><li>Proactive Strategies </li></ul><ul><li>Reinforcement Strategies </li></ul><ul><li>Reactive Strategies </li></ul><ul><li>Method for taking Data </li></ul>
    125. 128. Reinforcement Strategies <ul><li>Verbal </li></ul><ul><li>Proximity/Attention </li></ul><ul><li>Social </li></ul><ul><li>Material </li></ul><ul><li>Activities </li></ul><ul><li>Edibles </li></ul>
    126. 129. Consequences <ul><li>Decrease the efficiency of the target behavior while maintaining dignity and an atmosphere of caring </li></ul><ul><li>Never degrade or humiliate </li></ul><ul><li>Logically relate to the target behavior </li></ul><ul><li>Do not cause more of a problem than the problem they are addressing </li></ul><ul><li>Establishes conditions for learning alternative skills </li></ul><ul><li>Decreases the frequency, duration, and/or intensity of the target behavior </li></ul>
    127. 131. Positive Behavioral Supports & Balanced & Restorative Justice “P roviding Consequences that Teach and Restore”
    128. 132. Typical reactive responses <ul><li>Zero tolerance policies </li></ul><ul><li>Security guards, student uniforms, metal detectors, video cameras </li></ul><ul><li>Suspension/expulsion </li></ul><ul><li>Exclusionary options (e.g., alternative programs) </li></ul><ul><li>Retributive Justice </li></ul><ul><li>Punishment </li></ul>
    129. 133. Parallels to School-based and Community-based Retributive Justice
    130. 134. Balanced and Restorative Justice (BARJ)
    131. 135. View behavioral errors as opportunities to teach <ul><li>Consequences that restore </li></ul><ul><li>Consequences that teach </li></ul>
    132. 136. What is BARJ? <ul><li>Philosophy </li></ul><ul><li>Repair the harm </li></ul><ul><li>Victim, Offender, Community </li></ul><ul><li>Offence against people vs breaking the rules </li></ul><ul><li>Accountability </li></ul><ul><li>Safety </li></ul><ul><li>Competency </li></ul>
    133. 137. Restoration teaches self control through modeling, mediation, and community restoration Punishment teaches external control through punishment, loss, and exclusion.
    134. 138. Behavioral offences are wounds… Consequences should heal
    135. 139. Restorative Justice in School Communities <ul><li>Traditional </li></ul><ul><li>Misconduct defined as breaking the rules </li></ul><ul><li>Focus on establishing blame </li></ul><ul><li>Conflict represented as impersonal and abstract </li></ul><ul><li>Attention given to rules broken </li></ul><ul><li>School represented by member of staff dealing with situation </li></ul><ul><li>Accountability defined as receiving punishment </li></ul><ul><li>Restorative </li></ul><ul><li>Misconduct defined as behavior affecting others </li></ul><ul><li>Focus on problem solving </li></ul><ul><li>Conflict recognized as interpersonal with value for learning </li></ul><ul><li>Attention given to broken relationships </li></ul><ul><li>Total school community involved in facilitation restoration – empowerment </li></ul><ul><li>Accountability </li></ul>
    136. 140. References and other Resources to Consider <ul><li>Nurtured Heart Approach - Howard Glasser </li></ul><ul><li>Discipline, Love & Logic - Jim Fay </li></ul><ul><li>18 Step Treatment Approach -Russel Barkley </li></ul><ul><li>Understanding the Defiant Child -Russel Barkley </li></ul><ul><li>Attachment and Loss -John Bowlby </li></ul><ul><li>When Love is Not Enough -N.L.Thomas </li></ul><ul><li>Conduct Disorder in Childhood and Adolescence -A.E. Kazdin </li></ul><ul><li>1-2-3 Magic -Thomas Phelan </li></ul><ul><li>Lost Boys -James Garbarino </li></ul><ul><li>Raising Cain -Dan Kindlon , Michael Thompson </li></ul><ul><li>The Explosive Child - Ross Green </li></ul><ul><li>Discipline with Dignity -Richard Curwin </li></ul><ul><li>Changing Lenses -Howard Zehr </li></ul><ul><li>A Blueprint for School-wide Positive Behavior Support - R. Horner & G. Sugai </li></ul><ul><li>Life Space Intervention- Mary Wood & Nicholas Long </li></ul><ul><li>Talking With Students in Conflict:LSCI - Long, Wood, and Fecser </li></ul>
    137. 141. Question and Answer Time <ul><li>Wendy, Lisa, and Steve </li></ul>
    138. 142. Evaluations
    139. 143. “ If you treat an individual as he is, he will stay as he is, but if you treat him as if he were what he ought to be and could be he will become what he ought to be and could be.” Wolfgang Goethe

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