Welcome!

Celebrating Abilities Inc. started as a support group located in southwest Florida for parents of children with different abilities. We are no longer active as a group because we've all moved on to other areas of the United States. I've decided to keep the blog active so that information can be shared with our loyal families and some new ones, too.

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Have a blessed day!

Sunday, June 22, 2008

Coping with Oppositional Defiance

Coping with Oppositional Defiance

Does this sound like your child?

-
Often loses temper

- Often argues with adults

- Often actively defies or
refuses to comply with adults' requests or
rules

- Often blames others for
his or her misbehavior or mistakes

- Is often touchy or easily annoyed by
others

- Is often angry and resentful

- Is often spiteful and vindictive

Causes and Consequences:
It seems that oppositional defiant disorder arises out of a circular family dynamic. This is not to say that you
caused your child to have ODD. It is to say that there are characteristics about your child that resulted
in an unhealthy family cycle of interaction. An infant who is by nature more difficult, fussy, and colicky, may be harder to soothe and thus cause parents to become frustrated and to lack confidence in their parenting
skills. If they perceive their child as basically unresponsive, they may begin to anticipate that the child will be unresponsive or noncompliant and set up a self-fulfilling prophecy. As a result, the parent's anticipating
failure, may unresponsive or unreliable in return and inadvertently add to the child's feelings of irritability,
helplessness, neediness, and frustration.

As parents attempt to assert control by insisting on compliance in such areas as eating, toilet
training, sleeping, or speaking politely the child may demonstrate resistance by withholding or withdrawing or tantruming. As a child grows increasing negativism, defiance, and noncompliance become
misguided. But, these habitual ways of dealing with adults that persists long after the "terrible twos."

The more defiant and provocative the child's behavior, the more negative feedback is elicited from the parents. In their attempts to teach their child to behave properly, parent or authority
figures try reminding their child, lecturing them, removing privileges, berating, and physical
punishment, nagging and negotiating. Unfortunately, these behaviors give the child a sense of control and
therefore tend to increase the rate and intensity of non-compliance.Ultimately, it becomes a tug of war and a
battle of wills with everyone losing.

Because parents are so frustrated dealing with their child, their
system of discipline becomes inconsistent. At times they may be calm
and assertive. Other times they may explode in anger. At still other
times, they may withhold appropriate consequences which soon become
hollow threats. As the child continues to provoke and defy, parents often
lose control. Then, feeling sorrow and guilt, especially if they've
become verbally or physically explosive, parents may overcompensate with
excessive rewards or leniency in order to undo what they now perceive to
have been excessive discipline or punitive consequences.

When a child starts school, this pattern of passive aggressive,
oppositional behavior tends to provoke teachers and other children as well
an often begins a cycle of being denied recess, getting detentions or
suspensions; which further aggravates the problem

In many cases, oppositional disorders coexist with attention deficit/hyperactivity disorder. In this case, the
impulsivity and hyperactivity of ADHD can greatly amplify the defiance and
uncontrolled anger of ODD. Symptoms of ODD can also appear as part of major
depressive disorder, obsessive compulsive disorder, or mania. Some children
with separation anxiety disorder may also evidence oppositional
behaviors.

So, what do we do?

Unfortunately, there are no simple solutions. But, here are some of the key approaches.

Parent Training
Programs Some parents are helped through formal parent training programs.
The benefit of these programs lies in both parents learning to use the same techniques and to do so consistently. It involves parents learning to set the same standards and apply the same consequences
day in and day out so that oppositional and defiant children cannot pit once against the other or
push parents into over or under reacting and then feeling guilty for their own behaviors. Parents learn to communicate expectations and consequences clearly to their child, to enforce the rules
calmly but firmly, and to use positive reinforcement whenever they catch their child being good so they can increase the frequency of occurrence of desired behaviors.

Individual Psychotherapy
Finding a psychologist or play therapist with whom your child can develop a good relationship can be very
valuable. Often children with ODD feel as if they don't live up to their parent's
expectations and this frustration exacerbates their disorder.
When a therapist provides unconditional acceptance, the therapist is in a position
to help your child learn some effective anger management techniques that
decrease defiance and naturally lead to more positive parental feedback.
The therapist may also employ cognitive behavioral techniques to help your
child learn effective problem solving skills that will improve social
interactions inside and outside the home. The support gained through
therapy can counterbalance the frequent messages of failure to which the
child with ODD is often exposed.

Social Skills Training
Coupled with other therapies, social skills training has been effective in improving social behaviors that result from a child's angry, defiant approach to rules. Incorporating reinforcement
strategies and rewards for appropriate behavior helps children learn to generalize positive behavior.
Social skills training, can help children learn to evaluate social situations and adjust their behavior accordingly. Metaanalyses of research on social skills has shown that the only
successful social skills training interventions are those that provide training in the child's natural
environments (home and classroom) - so that generalization is built in.To accomplish this you will need your child's Individualized Education Plan (IEP) from school to includeCommunity Based Instruction using social skills training.

Medication is only recommended when the symptoms of ODD occur with other
conditions, such as ADHD, obsessive compulsive disorder (OCD), or anxiety
disorder. When stimulants are used to treat attention deficit/hyperactivity disorders, they also appear to lessen oppositional symptoms in the child. There is no medication specifically for treating
symptoms of ODD where there is no other emotional disorder. In lieu of medication, you might
wish to investigate EEG neurofeedback, a nonpharmacological intervention which is effective at teaching children to self-calm, thereby increasing their adaptability and decreasing oppositionalism that results from poor adaptability. In addition, if your child is often moody and angry, you may ask your pediatrician to explore the possibility of prescribing transcranial electrotherapy for your home. This involves the use of a
portable unit called Alpha Stim, which generates low voltage alpha waves (the kind of waves the brain generates when it is calm and focused). Your child can wear this noninvasive devise for 20-30
minutes per day, to induce a relaxed, peaceful state without need for medication.

Practical Suggestions for Parents

Enlist others to help you: You need help on a consistent basis. This means you need to
speak with your parents, your siblings, your husband's parents and siblings, your neighbors and let them know that your child has a disorder which is difficult to control and very demanding
on you as a parent. Therefore, you need help on a regular basis from now
until your child is grown. Ask each to commit to help in some concrete fashion. This might
mean that someone watches your child every week so you can go grocery
shopping without a hassle, it may mean that grandma has the kids for dinner
every Saturday so you and your spouse can have a meal and a conversation
without interruption. It might mean that Uncle Mike takes you son for a
bike ride on Sunday's after church so you and your husband can pay your
bills. You decide what you need, and ask each person in your support
network to make a specific commitment to help you. In short, do
everything you can to share the burden of parenting. This includes asking all
interested parties to learn about your child's disorder(s) and IDEA and
to participate in IEP meetings with the school district.

Set up an appropriate school program: If your child is not already classified,
make a written referral for your child to be evaluated for special education. Request a Functional Behavioral Analysis as part of the evaluation process. Once eligibility is determined, you want to
advocate for an IEP that include a Behavioral Intervention Plan with positive
behavioral supports to reduce the occurrence of oppositional and defiant behaviors. You also want this plan to stipulate that in or out of school suspensions may not be employed as a disciplinary measure with your child, and that your child may not lose recess. It is also important to have weekly counseling sessions with the school psychologist as part of your child's IEP with goals to develop relaxation and anger management skills, along with problem solving and coping mechanisms. Additionally,insist on having monthly parent training sessions in behavior management in your child's IEP so that you can carry over any effective interventions the school is employing to the home environment. Be certain that the IEP also indicates your child will be staying after school for aftercare and that a
staff member is to utilize this time to assist your child in completion of
all homework assignments and projects. This component is important because
it will eliminate a major source of conflict at home.

Finally, don't forget to make certain that the IEP includes community based instruction at
home and other locals your child frequently visits using social skills training.

Access community services:
Consider putting your child in daycare before and after school. Insist that homework is completed
in the afterschool program so that this source of conflict is eliminated from
the home environment. For weekends and holidays and summer vacations,
consider having your child participate in programs offered by Big Brother
and Big Sisters or Boy Scouts/Girl Scouts. Summer camps provide an
excellent opportunity for your child to "start over" with adults and
children who don't know their history of defiance and who will expect and
therefore automatically reinforce compliance. They also provide you much
needed time to self-nurture so that you will replenish your own
reserves and be better equipped to deal with your child when s/he arrives
home from camp. Don't forget to ask for help from your local religious
organization. Someone from your church or temple may be equipped
to provide some spiritual counseling for your child. This can be important
as prayers have been documented as an effective method of stress
management and anger control. Additionally, there may be someone who is
able to assist concretely by providing some much needed tutoring, or
picking up your families' groceries while they pick up theirs or even
picking up.

The last step is respite foster care on a regular
basis: If your child becomes too demanding and it begins to impact on your
own physical or mental health, consider respite foster care. This might
mean your child spending one weekend a month with a foster family in order
to provide a break for you to nurture not only yourself, but also
other children in the home, and your marriage. Many parents indicate that
they would feel like complete failures if this became necessary. In
reality, this is a healthy effective way to equip yourself to handle your
child's special needs over the long haul.

Make consequences relevant to the offense: Avoid using generic consequences such as time out
or grounding. Instead, customize the consequence to the offense. For instance, if your child throws a shoe and break your favorite crystal piece. Then, assign your child an hourly wage, and have him work over the
next several (days, weeks, months) to earn the money to replace that item.
Each day when it is time to do the extra chores, give a reminder that helps the child connect the behavior to the consequence. For instance, "Joey, it is time to rake the lawn to earn some more money towards paying for the crystal that broke when you choose to throw the shoe". If you child steals something, then the consequence might be a visit to the police station, witnessing some criminals in cells
and a discussion with a police officer about what happens to children who steal. If your child, lies then
the consequence might be to do a research report on the value of honesty.

Discover what your child is truly interested in:
Some children devote so much time to being disruptive that they never
develop any appropriate interest. This is another way that camps can be of
help. For instance, you might try a few sports camps, or a music camp, or
an art camp and in the process your child may discover something that
truly interests them; which can be used as a reward and a motivator during
the remainder of the year. If you haven't the funds for camps, try
your local YMCA as most will offer scholarships based on financial needs.
The YMCA and Big Brothers or Sisters and Scouting all offer positive
activities for your child to be involved in during the school year along
with opportunities to interact socially with nondisabled peers who may
provide good behavioral role models. These organizations all teach values
that include respecting parents and giving back to the community, and
thereby reinforce the values you are trying to teach your child.

·
Residential Schools:
If your child's behavioral problems grow to the point that you and your child's school have difficulty dealing
with them, consider a therapeutic residential school. This can be a
win-win-win situation. It alleviates the need for your ill-equipped local
school to address your child's behavioral needs, it provides, you, your
spouse and your other children extended periods of normalcy, and it
provides your child the structure and therapy that are needed in a
situation where they can no longer alienate those closest to them.
Additionally, when your child does come home for weekends, holidays and
vacation it is always an opportunity to start off on a positive note with a
clean slate. Moreover, relationships can be fostered while your child is
at school through letters, emails, on-line photo albums and phone calls
without having to deal with day to day conflict.

Someone to talk to: Whether it is a friend, relative, friend,
pastor, or a counselor, you need to be able to talk to someone on a regular
basis; and most especially when things are going badly. Issues you may
need some help with are:

· Carving
out time for your marriage

· Nurturing siblings of your difficult
child

· Communicating your child's home and community needs to
the
IEP team

· Issues that need to be addressed in your child's
behavioral
intervention plan

· Thinking about a residential
school

· Having a plan to deny privileges to a defiant child
without
denying siblings (i.e. someone to stay home with child when s/he
doesn't
deserve to go the movies but the other children do.

·
Considering respite foster care

· Dealing with constant lying

·
Dealing with thefts

· Coping with your child's physical
aggression

· Dealing with crimes that your child engages in

·
Disagreeing with your spouse about how to handle behaviors

·
Grieving the loss of the child you hoped for

· Seeing the school
system write off your child's needs

· Behavior management
techniques

· Effective advocacy within the educational
system

Some parents feel uncomfortable in face to face counseling. For
others
the only time they can squeeze in for sessions is in the evenings
when
their child is asleep by which time most therapists' offices are
closed.
Others don't want weekly assistance, but they'd like a familiar
person
they can contact when the need arises. In these situations,
internet
special needs coaching sessions may be a good alternative. You
schedule
these at your convenience when you need them and address your then
pressing
issues from the comfort of home. To schedule this type of session
go to
[http://www.specialeducationsupport.org/]
www.specialeducationsupport.org
and select the schedule tab.

How to begin
dealing with your child's behavior

· Start at ground zero. Tell
your child that his/her behavior
has not been acceptable and that the whole
family is going to start over.
Develop a list of expected behaviors and
consequences for noncompliance.
Post these in a predominant spot. Then,
develop a list of your child's
responsibilities and privileges that can
be earned by completing those
responsibilities without a hassle or
reminders. Start with only essentials
being provided: bedroom, basic
food, clothing etcetera. Make it so that
your children need to earn TV
time, computer time, having friends over,
visiting others, trips to the
library or bowling alley, and extra half hour
later bedtime, and so forth.
The children in your family without
oppositional and defiant behavior will
follow the same rules and as they
are already compliant should have no
problems earning their privileges and
setting a good role model.

- Build
on the positives, not the negatives. Create ways for your child
to
experience positive feedback. This might involve having them
participate
in a formal volunteer program in the community. Or, it may be
as simple as
asking them to tutor a younger sibling in an academic area
where they have
strength and then providing plenty of praise. Creating as
many
opportunities for positive reinforcement as possible, and in so
doing
create as many opportunities as possible for your child to help those
less
fortunate than themselves. This helps combat their feelings of
entitlement
and begin to understand the perspective and needs of others. It
also
provides opportunities for you to compliment their hard work in
their
undertaking. For instance, you might compliment your child for raking
a
disabled neighbor's lawn, for collecting recycling, for donating some
of
their allowance to a charitable organization for children, for
volunteering
at the humane society, for singing Christmas Carols in
nursing homes,
think of ways for your child to give back to the community;
and praise
those behaviors. As a general rule, each day children should
hear more
positive than negative comments about themselves.

- Use
teachable moments to your advantage. Kids with ODD would like to do
well,
but they have been prewired such that they lack the necessary
flexibility
to adapt easily to environmental demands. You can help your
child by
teaching adaptive skills. The easiest way to do this is to model
adaptive
behavior and to verbally mediate your actions. For instance, when
someone
cuts you off in the Wal-mart parking lot and steals the spot you
have been
waiting for. You can calmly drive on while saying: "That
person's rude
behavior was very upsetting, so I'm going to breathe
deeply to recompose
myself." Or, I'm really frustrated that I didn't
receive a promotion
at work after all the extra hours I have been putting
in. I know Joe got
the promotion just because he is friends with my boss.
So, I'm going to
direct the energy from my anger into looking for a new
job with more
advancement opportunities. Maybe you can help me print
copies of my resume
and search the internet for possible openings."
Involving your child in
these types of constructive actions can help your
child learn to
effectively direct their own anger energy into similar
constructive
activities. Or, you might say, "I'm tired and frustrated
and feel
grumpy, so I'm going for a walk to refresh myself. Would you
like to
join me?" Physical activity releases endorphins that improve our
moods,
so modeling physical exercise as an outlet for anger or frustration
is very
positive. You can also direct teach. For instance, if you see a
peer
tease your child, before the situation escalates you can step in and
say:
"Bob, I heard you teasing Joey. I'm certain that hurt his
feelings.
Now Joey may choose to ask you to go home, or he can choose to
ask you for
an apology. Joey what do you want to do?" Bear in mind
though, that
oppositional children tend to respond more positively to
verbally mediated
role modeling than they do to direct teaching.

- Pick your battles. Most
children with ODD are doing quite a few things
that you dislike, but if
everything is a battle you will get nowhere. If
something is simply
annoying you might choose to ignore the behavior. For
instance, if your
child interrupts while you are on the phone you might
tell the other party.
I need to get off the phone now and I'll call you
back later. Then, when
your child requests attention appropriately. Thank
him or her for waiting
until you were free to speak. Some things you may
be willing to
occasionally negotiate on. For example, if homework is always
to be done
before friend's visit; but a very good friend is visiting from
out of
town and has only this time to visit you might say to your child:
"Since
Paul is a special friend and is only here for today, we will make
an
exception and let you play now and do your homework later. But, if
your
homework is not completed without hassle by 7pm, then the next time
Paul
visits, we will not make this special exception." Some things
should
never be negotiated: being disrespectful, lying, stealing or being
violent
must always meet with consistent consequences.

- Take a break from
the conflict. If you lose your cool, the child will
see it and know that
s/he has the upper hand. Learn to take time to say.
"Right now, I am
very angry with you. Go to your room, while I think
about how we will deal
with this". Then, call a resource person or do
something that helps you
calm down. Later, when both spouses are present,
address the issue
jointly.

- Don't keep your child's misbehaviors a secret: When
your child has
chosen to be defiant and have a consequence doesn't hide
it. If they
can't go to the movies with Uncle Mike because they stole
something, tell
Uncle Mike the full reason. This may bring the reproach of
others to back
up your position that such behaviors are not acceptable. If
your child's
best friend may not come over because your child did not
complete his
homework, let the friend know: "Joey can't play today
because he
hasn't completed his homework. You may help him with his
homework or you
may come over another day."

- Quality time: When you
have a child who is oppositional and defiant you
may feel as it all or most
of your interaction with that child are
stressful and conflict ridden. To
counter this, when you child arrives
home, make certain you have a full
half hour free of other commitments.
Devote this time to engaging in an
activity of preference with your child.
For example, your child might enjoy
Webkinz; if so play this with him. Or,
your child might like a particular
Game Boy or Nintendo Game. If so, learn
to play it and have a contest.
Or, perhaps you have a child, who likes
certain board games, then sit down
and share some pleasant time together.
It might also be time painting or
drawing, or working on a wood working
project. The activities don't
matter, as long as your child enjoys it
and you get at least a half hour a
day of uninterrupted time with your
child engaged in a positive activity
together.

Additional Advice...

· Don't take it personally.
You child may call you
"mean", but they are really frustrated by their
own lack of
adaptability and are lashing out at the nearest target. When
this happens,
just tell your child that even though they are angry with
you, you love
them and will continue to do what is best for them.

·
These children are experts at pushing your buttons, so don't
let them.
Keep your composure, no matter how difficult. Do not fight with
your child.
If need be, walk away, take a bubble bath, use the Alpha Stim,
do deep
breathing exercises. Then, when you are calm, and your child is
calm
address the issue that gave rise to the conflict.

· Give genuine
choices. Give them appropriate control when you
can. For example, "Joey,
you need to clean your room today. You may do
it now and then have the
afternoon to play. Or, you can play for just two
hours and then stop to do
your room. Which do you prefer?" "Or, "
Joey, your teacher says your
are behind in AR reading. Do you want me to
read with you a half hour each
night at bedtime, or do you want to read a
half hour by yourself every day
before going out to play?"

· Connect with what you like about
the child. Don't forget
that he or she is a child with many wonderful
features. Work on that part
of your relationship and help them remember
who they are

Overall tips . . .

· Intervention should be as
early as possible.

· It should cover as much of the child's day
as possible every
day

· It should include all caregivers

·
It should be consistent across all environments and across
time

·
It should be maintained as long as needed (basically until
your child is
grown)

· It should include many different types of interventions
and
not just focus on one aspect of the problem

ADDITIONAL SITES WITH
INFORMATION ON ODD:

[http://www.adhd.com.au/conduct.html]
http://www.adhd.com.au/conduct.html
- Causes and treatments for
ODD/CD

[http://childparenting.about.com/library/blchildbehaviordisorder.htm]
http://childparenting.about.com/library/blchildbehaviordisorder.htm
-
Guide to resources for parents of children with behavioral and
mental
problems

[http://www.focusas.com/BehavioralDisorders.html]
www.focusas.com/BehavioralDisorders.html
- Broad resources addressing a
variety of problem behaviors and disorders
of children, adolescents and
young
adults

[http://groups.yahoo.com/group/oddparentsroom/]
http://groups.yahoo.com/group/oddparentsroom/
Chatroom for parents with
children with
ODD

[http://www.haworthpress.com/store/sampleText/J007.pdf]
www.haworthpress.com/store/sampleText/J007.pdf
- Innovative Mental Health
Interventions for Children: Programs that
Work

[http://www.ici2.umn.edu/preschoolbehavior/tip_sheets/hostagg.pdf]
www.ici2.umn.edu/preschoolbehavior/tip_sheets/hostagg.pdf
- Preventing and
dealing with challenging
behavior

[http://www.ici2.umn.edu/preschoolbehavior/tip_sheets/passagg.htm]
www.ici2.umn.edu/preschoolbehavior/tip_sheets/passagg.htm
- Dealing with
Passive Aggressive
Behavior

[http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm]
http://www.klis.com/chandler/pamphlet/oddcd/oddcdpamphlet.htm
Overview of
ODD, case examples, non-medical strategies for dealing with
ODD/CD

[http://www.lifematters.com/4goals.html]
www.lifematters.com/4goals.html
- An article that addresses the children's
underlying goals of typical
misbehavior and how adults can recognize
them

[http://www.youthchg.com/hottopic.html]
www.youthchg.com/hottopic.html -
Interventions for aggressive behavior in
children.
References

American Psychiatric Association (2000). Diagnostic
and statistical
manual of mental disorders (4th ed., rev.). Washington DC:
Author.

Carson, R. C., Butcher, J. N., & Mineka, S. (1998). Abnormal
psychology
and modern life: Tenth edition. New York: Addison Wesley
Longman.

Chandler, J. (2001). Oppositional Defiant Disorder/Conduct
Disorder
Pamphlet.
26 Mar, 2003.

Jabs, C. (1999). Is your child
too defiant? Working Mother, Mar. 99.
03 Jun, 2003.

Kazdin, A. E., & Weisz, J. R. (2003). Evidence-based
psychotherapies for
children and adolescents. New York: Guilford
Press.

Minke, K. M., & Bear, G. C. (2000). Preventing school problems
-
Promoting school success: Programs and strategies that work.
Bethesda, MD: National Association of School Psychologists.

Quay, H. C., &
Hogan, A. E. (1999). Handbook of disruptive behavior
disorders. New York:
Kluwer Academic/Plenum Publishers.

Webster-Stratton, C., & Taylor, T.
(2001). Nipping early risk factors in
the bud: Preventing substance abuse,
delinquency, and violence in
adolescence through interventions targeted at
young children (0-8 years).
Prevention Science, 2(3), 165-192.

Presented as
a community service by,
Susan L. Crum, B.S., M.S., Ph.D.
Special Needs
Coach
Able2Learn
Email: [mailto:Able2learn@live.com]
Able2learn@live.com
Voice and Fax: 863-471-0281
Website:
specialeducationsupport.org

This message was sent by: Able2Learn, 2880 Zankor Road, San Jose, CA 95134

1 comment:

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