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Case Study: ODD

I. Introduction

According to the American Psychiatric Association the definition of oppositional defiant disorder (ODD) is the recurrent pattern of negativistic, defiant, disobedient, and hostile behaviour toward authority figures that persists for at least 6 months. This is considered to be normal behaviour at most ages, particularly in younger children and early adolescence. The child’s openly uncooperative and hostile behaviour becomes known as ODD when it is so frequent and consistent that it stands out when that child is compared with other children of similar age and developmental level; this consistent behaviour can greatly affect the child’s social, family, and academic life. Additionally, ODD is considered to be the precursor to conduct disorder (CD).

ODD is typically diagnosed after a pattern of hostility towards parents, teachers or other authority figures is detected. In order for the diagnosis to be made, four or more of the following must be observed of the child: loss of temper, frequent arguments with adults, active defiance or refusal to comply with adults’ instructions, often deliberately annoying people, frequently blame other for his/ her mistakes or misbehaviour, is often touchy or easily annoyed by others, often angry or resentful, or is often spiteful or vindictive. ODD is often present along side other psychiatric disorders, so the child must undergo extensive testing and assessment to ensure the diagnosis is correct. Learning disorders, mood disorders or anxiety disorders may be present as well, and treating ODD may be difficult without first dealing with the coexisting disorder. In Newfound land these students would be considered to be criteria E or criteria F, having behavioural and/ or learning disorders.

The exact causes of oppositional defiant disorder are not known for certain. However, is known that behaviour that is normal for a two year old does not go away in a child with ODD. It is also known that if a parent has been in trouble with the law or is an alcoholic that the child is three times more likely to have ODD. Additionally, if a child has ADHD they are 30-40% more likely to have ODD. In younger children it is more prevalent in males than females, but as age increases the rate is closer to the same in males and females.

II. Classroom Strategies and Interventions for Teachers

As teachers we can expect to have a diversity of students in our classrooms, including those with learning disabilities or behavioural disorders. The following paper will discuss some accommodations and strategies that can be used in the classroom by teachers who are interacting with students who have oppositional defiant disorder (ODD) in their classroom. Since ODD is considered the precursor to conduct disorder, the strategies discussed herein may be considered for those students as well.

Group intervention is, essentially, a group of people, namely teachers, special education teachers and/ or parents working together to make all attempts of the student to annoy and provoke others impossible. People with ODD are often quite successful at putting blame for their actions on other people, so to get to the root of the problem behaviours the group must speak directly without the presence of the child to develop a plan of action. Typically the action plan describes how these people will react to the child’s behaviour. Showing little or no emotional reaction to the negative behaviours and rewarding the positive behaviours encourages change. The purpose of this behaviour therapy is to focus on key behaviours and eventually have them eliminated because there is a lack of response from the child’s authority figures.

Students with ODD tend to consistently challenge classroom rules, refuse to do assignments, and encourage conflict with the teacher or other students. This can seriously impair classroom functioning and create a stressful learning environment. While behaviour therapy is an option, there are more direct and yet subtle tactics that teachers can use in their classrooms. Below is an extensive list of strategies and accommodations used in many classrooms.

§ Choosing the appropriate battles to fight – sometimes there are some situations that need to be diffused, while others should be left alone to avoid further conflict or class disruption.

§ State the classroom rules clearly and concisely telling students which are non-negotiable, and avoid discussions that could result in a power-struggle with the student.

§ Provide material and plan lessons that encourage student interaction – Students with ODD often need to learn how to interact socially with their peers in a positive way. Praise students who respond positively to questions and tasks.

§ Ensure work is at an appropriate academic level – If it is too difficult students will become frustrated, if it is too easy they will become bored.

§ Make sure skills being learned by the students are relevant to their lives. Also systematically teach social skills: anger management, conflict resolution and how to be assertive in appropriate situations.

§ Provide consistency, structure and clear consequences for students’ behaviour.

§ Maximize the performance of students with ODD by using individualized instruction, cues, prompting, and breaking down of academic tasks. – These actions will be unknowing to the rest of the class, but gives the student with ODD a “heads up” in terms of doing well academically.

§ Allow students to redo assignments to improve their grade – students, like everyone else, learn from their mistakes, providing an opportunity to improve a grade can improve academic performance and behaviour in the classroom as students realize grades are one less item they can argue about.

§ When decisions need to be made, provide two choices – again, if the students themselves make the decision it is another avoided conflict of interest.

§ Arrange an appropriate seating plan with the student sitting near the teacher to ensure attention is focussed on the lesson, or have the student with ODD sitting here a student with whom they get along, and can effectively learn from in cooperative learning situations.

However short this list may be, the strategies and accommodations suggested have been tried and tested by many teachers in their classrooms and proven to be effective in preventing and diffusing tense situations.

III. Resources

American Academy of Child and Adolescent Psychiatry. (2005). Children with opposition defiant disorder – AACAP facts for families # 72. Retrieved on May 20, 2005 from http://www.aacap.org/publications/factsfam/72.htm.

This site provides a shorter description of ODD and the symptoms; however, this source has a list of strategies that parents and/ or teachers could use when they are dealing with these children. Not all of the suggestions in the list are ideal for use in a classroom, but many of them could be equally used in school as at home by a parent.

Chandler, J. (ND). Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) in Children and Adolescents: Diagnosis and Treatment. Retrieved on May 20, 2005 from http://www.klis.com/chandler/pamphlet/oddcd/ oddcdpamphlet.htm#_What_ can_be_done?

This website provides a simple and comprehensive discussion to answer some of the more common questions that may be asked. The author provides and explanation of oppositional defiant disorder (ODD) and its affiliation with ADHD, conduct disorder and other psychiatric disorders. The site provides an extensive list of the more common characteristics of a child who has ODD and the frequency that these characteristics need to be observed before a formal diagnosis can be made. In addition to talking about how to tell ‘if your child has ODD’, the author discusses at great length the complexities of ODD with regard to comorbidity. For combination he discusses, he provides a short story about children with each. Where ODD is considered a precursor to conduct disorder, this site is excellent in that it also provides information on this disability.

Focus Adolescent Services. (2000). Teen behavioural problems and behaviour disorders. Retrieved on May 20, 2005 from http://www.focusas.com/Behavioral Disorders.html

As with the previous resources this site provides a description of ODD, characteristics, and interventions that can be tried on a teen with ODD. This site, unlike the others, has more links to other aspects of this disorder as well as links to other disorders, providing parents and teachers with information on everything from ADHD to dealing with Satanism in teens.

U.S. Dept. of Education. (2004). Teaching children with attention deficit hyperactivity disorder: Instructional strategies and practices. Retrieved on June 5, 2005 from http://www.ed.gov/teachers/needs/ speced/adhd/adhd-resource-pt2.doc

This resource is primarily a guide for detecting and instructing students with ADHD, however, since ODD and ADHD very often co-exist in an individual this is a great document. It discusses some behavioural interventions and classroom accommodations for these students.

Minnesota Association for Children’s Mental Health. (ND). Children’s mental health disorder fact sheet for the classroom: Oppositional defiant disorder. Retrieved June 4, 2005 from http://www.macmh.org/publications /fact_sheets/ODD.pdf

This is an excellent resource sheet for any classroom teacher. At two pages in length it is a concise read that provides a short overview of ODD. The primary focus of this fact sheet is to inform teachers of classroom implications, and it does so in a succinct manner. The second page of the sheet provides a long list of classroom accommodations and teaching strategies for use in a class with children who have ODD. Many of the ideas discussed within this document were in this list. The sheet also lists addresses of associations from which teachers can obtain free resource materials.

Not My kid Inc. (2000). Oppositional defiant disorder in children – facts and strategies for parents. Retrieved on June 5, 2005 from http://www.notmykid.org/parentArticles/ ODD/default.asp

This site discusses the symptoms of ODD at different age groups and compares many of them with ADHD. This site was the primary resource on behaviour modification therapy as a non-medical method of intervention. The article does discuss some professional interventions including psychotherapy, parent-training and support classes, and medications. The doctors who wrote this article have discussed a number of suggestions for parents and even teachers for handling children with ODD.

Download this summary of ODD Characteristics