Overview of Disruptive Behavior Problems

Overview of
Disruptive Behavior
Students with disruptive behavior
disorders are a heterogeneous group
Most are boys
However, conduct problems are not
uncommon among adolescent girls
Overview of Disruptive
Behavior Problems
 Many youngsters exhibit individual
traits and behaviors in early childhood
that foreshadow a developmental path
leading to more destructive and
aggressive behaviors as adolescents
and adults
Overview of Disruptive
Behavior Problems
 One of the difficulties in identifying
these disorders is that a certain
amount of rowdy play
 Risk factors may contribute to the
development of these disorders
Overview of Disruptive
Behavior Problems
 Collectively, these risk factors are
producing children and youth who:
 A-see violence as a viable means of
solving problems
 B-don’t respect the rights of others
 C-are not socially responsible
 d-have not been taught basic manners
and social conventions
Overview of Disruptive
Behavior Problems
 E-don’t value human life as they should
 Individual factors that predispose a
child to disruptive behaviors include:
Overview of Disruptive
Behavior Problems
1- a difficult temperament
2-cognitive or learning impairments
3-neuropsychological problems
4-mental illness
Overview of Disruptive
Behavior Problems
Family predictors of disruptive behavior
 1-harsh and ineffective parenting
 2-parental antisocial and pathological
 3-parents with alcohol and drug
 4-interrupted parenting
Overview of Disruptive
Behavior Problems
 History of abuse or neglect
 Later adoption age
 Prenatal drug exposure
 Multiple foster placements prior to
Overview of Disruptive
Behavior Problems
School Factors that may contribute to
behavior disorders:
1-academic factors
2-negative relationships with peers
and adults
3-punitive school environment
Overview of Disruptive
Behavior Problems
Community factors include :
1-access to drugs and alcohol
2-exposure to violence
3-lack of educational and
employment opportunity
4-acceptance of aggression as a
problem solving strategy
Overview of Disruptive
Behavior Problems
 Treatment Options
1-Results of treatment interventions in residential
settings have not transferred to natural setting
including the home or school
2-School based group intervention studies have
been few in number and the results have
shown students with disruptive behavior
patterns to be very resistant to treatment
Types of Disruptive
Behavior Problems
 DSM-IV-TR (Diagnostic and Statistical
Manual of the American Psychiatric
Association) lists four clinical diagnoses
that may be appropriate for students with
specific patterns of disruptive behaviors.
These include:
Types of Disruptive
Behavior Problems
 A-Oppositional defiant disorder (ODD)
 B-Conduct disorder (CD)
 C-Disruptive behavior disorder-not
otherwise specified (DBD-NOS)
 D-Intermittent explosive disorder (IED)
Oppositional Defiant
Disorder (ODD)
 DSM describes oppositional
defiant disorder as a recurrent
pattern of negativistic, defiant,
disobedient, and hostile behavior
toward authority figures that
persist for at least 6 months.
Oppositional Defiant
Disorder (ODD)
Behaviors of ODD include:
1-losing temper
2-arguing with adults
3-defiance/noncompliance with adult requests
4-deliberately annoying others, blaming others or
being easily annoyed
5-angry/resenstful attitude
6-spiteful/vindicyive attitude
Oppositional Defiant
Disorder (ODD)
 Actively defy rules
 Deny responsibility for their behavior
 Exploit others for their own gain
 Students with ODD seem to thrive on
conflict, anger, and negativity from others
and are often most difficult with the
people they know well
Oppositional Defiant
Disorder (ODD)
 Prevalence: between 1% and 6% of the
population-Surgeon General’s Report
 DSM reports it as between 2 and 16%
 More common in males who were
tempermental or hperactive preschoolers
 ODD prevalence after puberty is equal
between boys and girls
 Generally observed before the age of 8 but
may emerge through late adolescence
Oppositional Defiant
Disorder (ODD)
 Co morbid condition: a condition
or disorder occurring concurrently
with another disorder
 ODD often occurs with ADHD which
complicates the diagnosis
Oppositional Defiant
Disorder (ODD)
 Experts have described ODD as a
developmental antecedent to Conduct
Disorder (CD) for a significant number of
 If this occurs the diagnosis should be CD
rather than ODD
Conduct Disorder (CD)
 DSM describes CD as a
repetitive and persistent
pattern of behavior in which
the basic rights of others or
age-appropriate societal
norms or rules are violated
Conduct Disorder (CD)
 They describe these behaviors as
fitting into four groups:
 1-Aggression toward people and
animals\2-Harm to property
 3-Deceitfulness or theft
 4-Serious rule violations
Conduct Disorder (CD)
Associated features and mental disorders that
may occur with CD, as follows:
 1-little empathy or concern for the rights and
feelings of others
 2-Frequent misperceptions of others’ intentions
as hostile or threatening and responding with
Conduct Disorder (CD)
 3-Callous, lack of feelings of guilt or
 4-Low or overly inflated self esteem
 5-Early onset of risk-taking behavior
including sex, drinking, smoking,
using drugs
Conduct Disorder (CD)
 6-High rates of suicidal
 7-Lower than average
cognitive ability, especially
verbal IQ
Conduct Disorder (CD)
 The long term prognosis for students with
CD is grim
 Prevalence between 1 and 4%
 More than ¼ to ½ of all individuals with
CD go on to become antisocial adults
 DSM indicates between 1-10% of the
 Higher than males than females
Conduct Disorder (CD)
 CD may be evident as early as preschool, but
most significant symptoms emerge from middle
childhood through middle adolescence
 Childhood-onset CD is most common in males
and is frequently preceded by a diagnosis of
ODD. Early diagnosis has a poor prognosis
 Co morbid conditions with CD
Disruptive aBehavior
Disorders-Not Otherwise
Specified (NOS)
 DBD-NOS is used by DSM to
classify children whose
behavior is
oppositional/defiant or
conduct disordered, but does
not meet all the required
criteria for either ODD or CD.
Intermittent Explosive
Disorder (IED)
 While the DSM-IV TR does not classify
intermittent explosive disorder (IED) as a
disorder often diagnosed in childhood or
adolescence, it is a diagnosis some
students bring with them to school. It is
characterized by infrequent, unexpected
outbursts of disruptive behavior that result
in significant harm to people and/or
General Rules for
Classroom Management
 The most important element in classroom
management is to have a plan. Answer the
following questions to see if you are 'ready
for anything'.
 1. What do students do when they come
into your classroom in the morning? After
recess and lunch?
2. What is the consequence for not
completing assigned work both in class and
3. What is the consequence for student(s)
interrupting the class or a small group?
General Rules for
Classroom Management
 4. How do your students request to leave
the room for a drink or to visit the
5. What is the process for the whole
class leaving for lunch or recess or to go
to the gym?
6. What is the consequence for the child
who forgets things?
General Rules for
Classroom Management
 7. After giving a set of instructions or
directions, what is in place for the
student(s) that still don't understand?
8. How do you respond to the child that
keeps leaving his/her seat?
9. How will your students know about
acceptable voices/noise levels to use for
the various activities?
General Rules for
Classroom Management
 Basic psychology of children with
behavior disorders-What the teacher
needs to know.
 Level I Behavior Disorders
 Level II Behavior Disorders
Management of Conduct
 The youth at highest risk of extreme
violence may be the conduct disordered
 Remember that the hallmark of being a
conduct disorder (c.d.), is having no
heart, no conscience, no remorse.
Management of Conduct
 Only a mental health professional can
diagnose a conduct disorder for sure, but
being aware that you may have a
conduct disordered child in your class or
group, is important to ensuring your
safety, along with the safety of your kids,
because you work with conduct disorders
completely differently than other kids.
Management of Conduct
 Since the c.d. child has little relationship
capacity, you should not use relationshipbased approaches with a diagnosed
conduct disorder.
Management of Conduct
 It would be insensitive to call a conduct
disorder a "baby sociopath," but that is
close to what the term means. It means
that the child acts in ways that appear to
be seriously anti-social, and the concern
is that the child may grow up to be a
sociopathic type of person
Management of Conduct
 Since this child cares only about
himself (c.d.'s are predominately
male), there are little brakes on this
child from serious or extreme
Management of Conduct
 DO'S:
 *The main point we give in our classes is
that these children operate on a costbenefit system, and that to control your
c.d. kids, you must keep the costs high,
and benefits low.
Management of Conduct
 *Your goal is to teach them that when
they hurt others, it often hurts them too.
All interventions must be in the context of
"I-Me," because that is all this kid is
capable of caring about.
Management of Conduct
 Don't: have a heart-to-heart relationship.
 *Don't work on building trust.
 *Don't put an emphasis on compassion,
caring, empathy, values, morals.
 *Don't expect compassionate behavior.
 *Don't trust.
 *Don't give second chances.
 *Don't believe they care or feel remorse.
Management of Conduct
 Conduct disorders are "wired" differently than
other students. That means that they may not
be able to care. Because of that difference, the
following interventions will fail: character ed,
values clarification, empathy building, second
chances, making amends, and more-- far too
many to list here. These methods fail because
the child must care about others if these
techniques are to work.
Management of Conduct
 These approaches are absolutely fine for
other types of children, but will never be of
value with C.D.s. In fact, these methods
make the situation worse because they
communicate to these children that you
don't understand who they are, and don't
understand how to control them. That
perception generally leads these
youngsters to believe that they may be able
to do whatever they want without having to
deal with consequences that would be of
significant concern to them.
Management of Conduct