myteachertrainingprogramDisruptive Behavior Disorder - Not Otherwise Specified

Disruptive Behavior Disorder Not-Otherwise-Specified

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Hel lofel lowB-Lister! Aswecontinuewithourevery-weekenddiscussionof"Thekids inourclassroom",thisweekwe lookagainatoneof ourgreatestconcerns:Disruptive Behavior. Today,we lookat itthrougha medium-strength lens.

We’vetalked previouslyaboutAttention Deficit Hyperactivity Disorder (ADHD),Oppositional DefiantDisorder (ODD)andConductDisorder (CD).Al l threeconditionsarefound inasectionof the DSM-IVtrmental health manual titled“Attention-Deficitand Disruptive BehaviorDisorders”. Butthereisonemorecondition inthatsectionthatwe haven’tyettalkedabout:Disruptive BehaviorDisorderNotOtherwiseSpecified(NOS) (orthe ICD-9equivalent, “Conduct Disorder

NOS”).

In orderto warrant a diagnosis of Disruptive BehaviorDisorder–NOS,a youngster must be ruled out ofADHDasthe primaryissue(although itcanco-existwith DBD-NOS. . . referredtoasbeing"co-morbid"),anddisplaysomeof thecriteriaof ODD(often a precursortoCD)and/orCD,butnotenoughtoful lyenterthose domains.The NotOtherwiseSpecifieddiagnosis indicatesthatthere is a real and significantbehavioural maladjustment,butmoretimeand information isnecessarytodetermineif itenterstherealmsof ODDandCD. Strongevidenceof impairedsocialabi l ities,problematicinteractionsathome,and/ordisruptiveactions inschoolandathomehasbeendocumented,but it is,atpresent,notfarenoughalongthecontinuumtojustifytheODDorCDdiagnosis. DoestheNOSlabel sounda bittentativeoreventimidlyavoidant? Does itstrikeyou asa catch-al lgarbagecandiagnosis intowhichany

vagueand nebulousbehaviorpatterncan bethrownclaims,buttherearealsoval id reasonsfortheidentifier:

 Thecircumstancesof theyoungster’s behaviorare unique

 The behavior isperplexingandoddlystructured

 Continuedobservation isnecessarytoruleoutotherpossibi l ities

 Moreinformation needstobegathered beforeaspecificand moreintensivediagnosiscan bemade

Oneof thewonderfulgraduatestudents in myteachertrainingprogram in behaviordisorderscreatedagreatPowerpointsl ideshowonthetopic. Usingthecase historyof a hypothetical,but real isticstudent(“C”), the behavior isal ignedwiththe DSMcriteria beforeapproachesand interventionsareidentified. Youcanfindthescriptforeachsl ideinthe notessection under it.

Here are a few more suggested approaches and strategies:

1.Rob Plevin’s3freevideosonworkingeffectivelywith disruptiveclasses issti l l avai lable.

2.Developa removed,butcaringapproachwhen deal ingwithdisruptiveactions.Oneof the bestpiecesof adviceI ever receivedwasfroma mentorassignedtohelpmebackwhen Iwashavingproblems intheclassroom. Iwastakingthingspersonal lyand reactingina negative,hosti le mannerbecausethesekidswerekeepingmefromteaching.Mymentortold meabouthowtheemotionsthatwefeel aredependentonthewayinwhichweinterpretsituations.Whena kidwouldactout, insteadof thinking"Dammitt. Thiskid isgettinginthewayof myteachingandthelearningof others. I 'm lettingthiskidknowwhoisboss", I learnedtothink"Kid incrisiswhoneedscompetentassistancerightnow. HowcanI helphim/her?" Insteadof resentment leadingtoanger (anger isasecondaryemotionthatfol lowsaprimaryone), I feltcompassion. Helpful, supportiveinterventionscametomind. Sizingupasituationdifferentlybringsoutthe masterteachermindset.

3.Teachthebehaviorswewishtoseevia model ing.

4.Directlyteach appropriateactions, social ski l ls,angermanagementstrategies,problem solving,andself-control .

5.Getthecounselor involved inteachingcognitive behavioral strategies (Howtosize upsituationsdifferently, thus influencingfeel ingsand actions).

6.Provide moresupervisionthan isnecessarywithotherstudents.7.Bui ld positive relationshipstoenhancechancesof cooperationand compl iance.

8.Make use of strong, research-supported,positive interventions

8a.Differential reinforcement: It's a twenty Peso/Yen/Deutchmarkterm fora one monetary unit idea,butthe differentvariationsof the DR procedure are highlyeffectivewith intervention resistant kids.8b.Self monitoring:Promoteself-regulation of behaviourbyhavingthestudent keeptrackof his/herbehavior. .

9.Pickup additional defiance-defusingtips.

10.Teach problemsolvingskillstodevisealternativesolutionstoangerand rebel l ion.

11.intervention. This model and materialscan"turn around"anerrantkid. It'sa powerful and positiveapproach.

12.readinesstochange his/herbehaviour. Basedontheoucomeof theassessment, strategiesareprovidedto movetheyoungstertoward greater levelsof wi l l ingnesstochange his/herbehaviorforthe better.

13.trouble”. Theself-help bookforkidswith behaviordisorderscontinuestoreceive RAVEreviews. Put inonthebookshelf oruseitasthesocial ski l lscurriculum.

14. ImplementtheFREE100+lessonplansthataccompanyThe BehaviorSurvivalGuide(orusethem inisolation)

15.Engage the youngster in Multi-SystematicTraining(MST:http://mstservices.com/index.php/what-is-mst)

16. Forgirlswhotendto memoreresponsivetopeer-influenceandempathy-based interventionsthanboys,provide this intervention focus.

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Parents

1.Developa home-school behaviorchange program basedonthe monetarysystem.

2.forhelpingyourchi ld makebetterbehaviorchoices.

3.trouble”outonthecoffeetableforyourchi ldto pickup.

4.Seekoutfami lycounsel ing.

5. If yourchi ld isengagingindrugabuse, seekoutdrug-exitprograms. One researchstudyshowedthat1/2of druguserswith conductdisorderno longerexhibitedthedisorderwhenfreeof i l l icitsubstances.

6. Forgirlswhotendtomemoreresponsivetopeer-influenceandempathy-based interventionsthanboys, seekoutthis intervention focus.

7.Acquirethecomprehensive program designed specifical lyto help parentsof chi ldrenwith ConductDisorder/highlydisobedientbehaviorchangetheirchi ld'sbehaviorforthebetter. (Cl ickontheTotalTransformation box below)

NEXT WEEK:Anxiety.

Best regards,

Dr.Mac

Author:Tom McIntyre,Ph.D. DoctorMac@BehaviorAdvisor.com