Oppositional Defiant Disorder and Conduct Disorder

1. Oppositional Defiant DisorderandConduct Disorder Two Disorders that DO NOT QUALIFY for special education services Dickey LaMoure Special Education Unit

2. Oppositional Defiant Disorder

3. Oppositional Defiant Disorder: ODD • An identifiable disorder that is defined in the DSM IV as follows:“A pattern of negativistic, hostile, and defiant behavior lasting at least six months during which four or more of the following are present--

4. Diagnostic Characteristics of ODD • Often loses temper; • Often argues with adults; • Often actively defies or refuses to comply with adults’ requests or rules; • Often deliberately annoys people; • Often blames others for his or her mistakes or misbehavior; • Is often touchy or easily annoyed by others; • Is often spiteful or vindictive

5. Definition Continued… • Consider a criterion met only if the behavior occurs more frequently than is typically observed in individuals of comparable age and developmental level

6. Facts about ODD • More common in boys than girls; • Found in 16-22% of school-aged children; • Onset usually between the ages of 8 and adolescence; • Most common psychiatric problem in children.

7. Causes of ODD No one knows for certain. • Usually problems begin between ages 1-3. Many of the behaviors are normal at age 2, but they never go away. • ODD tends to run in families. • If a parent is alcoholic and has been in trouble with the law, their children are 3 times as likely to have ODD.

8. How is ODD Diagnosed? • Examine the child; • Talk with the child; • Talk with the parents; • Review the medical history; • Run additional medical tests to rule out something else.

9. Prognosis for children with ODD • Some outgrow it, but it is unknown how many—probably the minority; • ODD may turn into Conduct Disorder; • Most commonly, the child will continue to have ODD; • Children with ODD may develop mood disorders or anxiety as they get older.

10. ODD Seldom Exists Alone • ADHD (30-40% of the time children with ADHD will also have ODD) • Depression and Anxiety (15-20% of children with these conditions will have ODD)

11. Conduct Disorder

12. Conduct Disorder: CD • Severe ODD can lead to CD. • The biggest characteristic that separates ODD from CD is safety. • CD is the hardest pediatric neuropsychiatric disorder to live with as a family member.

13. Definition of CD A repetitive and persistent pattern of behavior in which the basic rights of others or major society rules are violated. At least three of the following criteria must be present in the last 12 months, and at least one criterion must have been present in the last 6 months:

14. Diagnostic Characteristics of CD • Aggression to people and animals; • Destruction of property; • Deceitfulness or theft; • Serious violations of rules.

15. Prognosis for Children with CD • 30% continue with CD into adulthood; • More common in males; • Substance abuse is very high (50-70% of 10-year-olds with CD will be substance abusers later); • 70% of children with CD show no signs as adults; • With other disorders, the CD may go away but the other psychiatric disorders remain.

16. CD and Other Disorders • ADHD: 30-50% of children with CD have ADHD. • Depression/Anxiety: ¼ to ½ of children with CD have either depression or anxiety. • Substance Abuse • Learning Problems • Bipolar Disorder • Tourettes

17. What Can Be Done? • Parent training programs to manage behavior; • Individual therapy to develop anger management skills; • Family therapy to improve communication; • Cognitive behavioral therapy to assist problem solving and decrease negativity; • Social skills training to increase flexibility and improve frustration tolerance.

18. The End