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Jerry Webster

Is Oppositional Defiant Disorder Real?

By January 22, 2012

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This past week I began my first class for my BCBA (Board Certified Behavior Analyist,) Management and Modification of Children with Special Needs.   My instructor, Nancy Brown, comes from a career of teaching the emotionally challenged population in self contained programs.  I look forward to hearing and sharing the strategies my classmates, many of them special educators or teacher preparing to be counselors, have to share.

At the same time, half way through the year I'm finding a lot of people are looking for resources to help them deal with difficult children.  I took a look at the articles that are already here, and found them lacking.  My predecessor was Canadian, and seemed to work with middle class children, rather than the sort of severe or challenging children that many of us deal with daily.  That is especially true for teachers in inner city schools, or teachers in rural communities with low socio-economic status. I felt it was time to revisit and rewrite the article about Behavioral and Emotional Disabilities.

My first job was to go back to the DSM (Diagnostic and Statistical Manual) IV and actually look at the criterion for some of the behavioral disorders that qualify as "Emotional Disturbances" under IDEA, the Individuals with Disabilities Education Act.   As I read the criteria, I had to ask myself  "How much of this is conditioned by the environment?"  "How many of these behaviors may actually be appropriate survival mechanisms?"

The DSM IV TR begins the definition with:  "A pattern of negativist, hostile, and defiant behavior lasting at least 6 months . . ."

The behaviors they describe are:

  1. Often loses temper
  2. Often argues with adults
  3. Often actively defies or refuses to comply with adult's requests or rules
  4. Often deliberately annoys people
  5. Often blames others for his or her mistakes or misbehavior
  6. Is often touchy or easily annoyed by others
  7. Is often angry and resentful
  8. Is often spiteful or vindictive.
  9. Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level.

Often?  How often?

The Manual also notes that behavioral disorders appear most frequently among boys, and that there is a higher reported prevalence in minority and low socio-economic communities.  Surprise!

Having taught in inner city schools, it seems to me that these behaviors seem to typify the way people in these communities deal with each other and the lack of opportunities in their communities.   Who wouldn't be angry, when your father left the family because he couldn't support it?  Who wouldn't be angry, in a community where half of the adult males are either in jail, or have been in jail?

Add to that the fact that many inner city teachers believe that screaming is an effective way to improve student behavior.  Not!

My second year in Philadelphia, our fourth grade participated in an Arts Project to encourage our children to create and participate in a musical and dramatic performance.   One of the visiting artist's teams shared their experience.  What a nightmare.  They taped a couple of their sessions and the classroom was completely out of control.   I knew some of the staff, and they told me that not only did the teacher not provide the structure the class needed to succeed, the principal did not support the teacher in creating a safe and well run classroom.  Problem students were sent back from the office. Were some children ring leaders?  It was evident from the tape.  Where they ODD?  Or were they the result of poorly trained teachers and poorly run classrooms?  Hard to say.

I wonder if Oppositional Defiant Disorder is a label that lets us shuffle these students out of general education classrooms when their teachers don't have the skills to manage or improve behavior.  Like mental hospitals in the Soviet Union, we slap anyone who disagrees with us in "treatment."

I hope that as I create new tools to help you manage and change your students behaviors, you will find resources to help you support your students' success.  I have seen teachers in inner city classrooms make it happen.  I have made it happen, with intensive reinforcement and consequence plans.

Comments

January 23, 2012 at 3:42 pm
(1) D. Logan says:

I taught for seven years in a secondary classroom. Counselors would put learning disabled and behaviorally challenged students in my class, because they knew I could get them to learn. I had exactly one student who was ODD. He learned the behavior at home – I also knew his mother, rather well by the end of the year in fact. She was another teacher in the district.

He seldom acted out in my classroom because I didn’t push him to do things he wasn’t ready for, and I didn’t tease him about his unreadable writing. He was a very bright young man, but had issues with writing (he needed a scribe, but his Mom refused to let him be “labeled”).

I agree that people are not born ODD, but they are formed by their environment. That shouldn’t make it less real or less of a disability. And yes, it may be an effective coping mechanism on the street or in certain cultures, but it’s a definite disability if you want to get a job.

And finally, please stop blaming the teachers. Teaching in an inner city school with no support from your administration and no resources (we often had to supply our own paper, on pitiful salaries) is a very frustrating job. When the children scream, eventually one screams back. It can become a very bad habit, but not one that any teacher really believes in. If we support our teachers to become better teachers, instead of always blaming them, we will have better teacher.

January 23, 2012 at 8:57 pm
(2) specialed says:

I’m not blaming inner city teachers: I have worked with many effective, dedicated teachers in low socioeconomic and minority communities (My current school is 80% free or reduced lunches.) There were a few screamers. I blame a society that puts so little value on public education that they don’t provide the resources teachers need, wherever they teach, as well as the income to attract and keep effective teachers.

January 23, 2012 at 4:51 pm
(3) Karen Smith says:

Support must include training or it IS NOT SUPPORT… in most cases.

January 23, 2012 at 8:57 pm
(4) Sandy says:

Parents at their best can have a difficult time managing their child with behavior issues. Teachers are not trained medically, and disabled children rarely only show behaviors just in a school setting. It has to be a combined effort of school and parent to be on the same page. It’s also just as prejudicial to blame a teacher or school system as it is to blame
” the way people in these communities deal with each other and the lack of opportunities in their communities. Who wouldn’t be angry, when your father left the family because he couldn’t support it? Who wouldn’t be angry, in a community where half of the adult males are either in jail, or have been in jail?”
You forgot welfare.
I just can not believe I read that. How offensive and prejudice is that?
I can not believe this as well “Add to that the fact that many inner city teachers believe that screaming is an effective way to improve student behavior”.
Really? Just because some may behave that way, it certainly doesn’t depict all of the teachers.

This certainly is not the way to begin to start creating new tools to manage behaviors in the class room.

January 23, 2012 at 10:13 pm
(5) AnOldFriend says:

Jerry, looks like you took a hit on this one.

I see both sides of this story. No, it is not ok to simply blame the teachers but I have seen the same type of teachers in many a setting. Lets be real folks, teachers like that ARE out there. Teachers are taking a lot of hits right now, both in the paycheck and in the classroom. Many are expected to work miracles with less supplies and more students. I understand if we are a little extra sensitive, but this guy is one of us, so let’s relax a little.

As for ODD…. Yes it does exist. I have taught people with it. A co-worker of mine has several students with that diagnosis in her class right now. She does a wonderful job with them. But they still display the same type of behaviors as Jerry listed in the article, just less and less often.

Is it possible for a teacher to create ODD-like behavior by things they do? Yes, I think it is.

What is our job? I think our job is to think about our students and think about ourselves and make sure that we are not making more problems while solving the ones that are brought to us.

Jerry, I think you were doing some of that thinking that every educator, student, and educator/student should do. Thank you for your thoughts.

January 23, 2012 at 10:37 pm
(6) Beth says:

Jerry,
What is real?
As a 24/7 parent (plus his Dad at 24/7 also) for 18 years (boy), I only offer a snapshot.
My son was diagnosed ADHD then depressed then bipolar and then ODD.
Now at age almost 19– 9 months away from home (because I and his father were completely leveled) and is living/working with a nonprofessional (our family) couple.
Until two years ago, I had no clear picture of what was “real” with him and questioned the situation and personalities/perspectives everyday. I was able to sit down with his therapist when she asked if I thought he “fit” into the Asberger’s “box.” After years of unpredictable blowups and fear for my own safety-I reluctantly told her no. As I read further PDD-NOS, I told her that this category fit him best even though vague. She smiled and stated that no one would diagnose him as having autism
Looking back and after having his disability application denied, PPD-NOS is the grouping he has belonged in since age 3.5, but honestly I believe that all who were involved in his care and education (we home schooled for the last 4 yrs) believed that he “was too smart” for this diagnosis. He cannot function for all ADL’s, handling money, social queues/interaction and a host of others.
My point is, behaviorally, he fell perfectly into the diagnostic categories of all 4 dx’s, but these “boxes” did not serve him. I believe that some of the ODD symptoms are those identified in autism for a child who was smart, frustrated, bullied, called lazy by several of his teachers. A child who was unable to vocalize his feelings or give/implement instructions.
Autism categories are changing in 2013. If he couldn’t be identified with the current guidelines, how will other children be identified/served after the changes? Shrinking Economy/Entitlements/Educational services…

Survival of the Fittest and throw the rest in jails=
Federal 2009 was $25,251/inmate. annual (State) Corrections Center 2009 was $24,758 (U.S. Prisons Bureau)

January 24, 2012 at 7:41 pm
(7) ilovecheese says:

As a former mental health therapist and now a SPED teacher who has taught in both affluent suburban schools and in 100% free/reduced lunch urban schools, I can tell you that ODD is real. I have seen kids in therapy who had a formal diagnosis along with kids in alternative schools and public schools who would fit the criteria but were undiagnosed.

In my state (Illinois) ODD is not recognized as an educational disability per se but if a student were diagnosed by a professional, he would get an “emotional disturbance” label since that is a recognized disability.

I am not sure what the connection is you are making to a DSM diagnosis and an educational disability. The two are often vastly different and a school psychologist cannot make DSM diagnoses.

It does seem as though you are parading some of the most commonly held stereotypes about urban schools about. The notion that people engage in bad behavior, kids are angry because of their bad circumstances, etc. Sure, that happens. It also happens that students have two parents with no criminals in the family. Some even have parents who are involved in their child’s education and won’t put up with any nonsense. Many of the parents in my school are the working poor – a minimum wage job or two and want better for their child.

Whether ODD exists or not is really a moot point in SPED since effectively managing inappropriate behaviors is the same regardless of the cause. I don’t treat defiance, opposition, lying, fighting, refusing to do work, etc. any differently with a child with an ED label or one with an Autism label. The point is to teach the child more appropriate behaviors so that he can be successful.

January 26, 2012 at 7:58 am
(8) Bunny says:

Thanks Jerry for your this website and sharing your knowledge of Special Education. I also want to thank those who understand and give support to the teachers in urban communities. We have little support from administrators and political leaders. People need to open their eyes to the truth of what is really happening in our schools.

Teachers can not solve ALL of the problems out there

January 30, 2012 at 9:01 pm
(9) Elizabeth says:

Hi there

I have a child displaying all the behaviours of ODD in my class. I’ve just come across the definition recently, and am reluctant to apply it. This child’s behaviour really reached the level at which it is, when his family started to implode. As far as I can see, he feels in agony at having been ‘discarded’ by his father.

Yes, he has now landed up with an almost habitual set of awful behaviours, out of which he seems almost unable to break. But labelling him with a ‘disorder’ would take away any of the real blame which, in this case, belongs with adults in his environment.

I’m not implying in any way that parents, teachers or whomsoever are often or usually the cause of “ODD” – only that diagnosing a disorder in the child moves the focus away from whatever the root cause may be.

As with the over-diagnosis of naturally lively boys forced to sit at desks all day, as ADHD.

January 30, 2012 at 9:15 pm
(10) specialed says:

Wow! What a wonderfully nuanced and contextualized understanding of behavior. I agree, family dynamics may be fueling this poor guy’s anger.

A suggestion that worked for me: I once had a child who was driving me crazy because he wanted attention. His mom (a single mom with a good head on her shoulders) said to me, “Jerry, I know it’s against everything they say, but I found if I give Jay a little extra attention, he’s a lot better.” I caught him being good, asked him to help after school, and he quickly became one of my best behaved, most compliant students. I think a little TLC from you, Elizabeth, will do this guy a world of good.

August 27, 2013 at 5:31 pm
(11) Molly says:

Although I agree that the behaviors of Oppositional Defiant Disorder are real, I don’t believe it to be an actual disorder. It makes more sense that it is rather a symptom of another disorder or multiple disorders.

In my opinion, the kids being labeled as ODD are just struggling and trying to cope with depression, anxiety, and/or ADHD. I probably would have been classified as having a mild case of this disorder if I was a child growing up in today’s society. In hind sight, I was just in complete misery, suffering from ADHD, depression and anxiety. I didn’t know why I felt so horrible, and I had no good way of dealing with my feelings, so I acted out. Acting out was the only thing that would give me some momentary relief.

I believe many of these children are just like I was, in that they are only exhibiting behavioral problems due to lack of treatment of the underlying issues. The frustration you feel as a child trying to cope with depression and anxiety would make anyone “oppositional” or “defiant”. Anger is the only way young people know to release frustrations and to get the attention they need.

I wish mental health professionals would stop labeling kids with this disorder, and instead try to get the bottom of why they’re acting that way. They need to redefine mental disorders to account for how they are expressed differently in children. I think if they did this, the diagnostic criteria for anxiety and mood disorders would look a lot more like ODD.

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