I received this through a listserve for parents of Asperger kids. It contains alot of useful, practical tips.
Coping with Oppositional Defiance
In many cases, oppositional disorders coexist with attention deficit/hyperactivity disorder. In this case, the
impulsivity and hyperactivity of ADHD can greatly amplify the defiance and
uncontrolled anger of ODD. Symptoms of ODD can also appear as part of major
depressive disorder, obsessive compulsive disorder, or mania. Some children
with separation anxiety disorder may also evidence oppositional
behaviors.
So, what do we do?
Unfortunately, there are no simple solutions. But, here are some of the key approaches.
Individual Psychotherapy
Finding a psychologist or play therapist with whom your child can develop a good relationship can be very
valuable. Often children with ODD feel as if they dont live up to their parents
expectations and this frustration exacerbates their disorder.
When a therapist provides unconditional acceptance, the therapist is in a position
to help your child learn some effective anger management techniques that
decrease defiance and naturally lead to more positive parental feedback.
The therapist may also employ cognitive behavioral techniques to help your
child learn effective problem solving skills that will improve social
interactions inside and outside the home. The support gained through
therapy can counterbalance the frequent messages of failure to which the
child with ODD is often exposed.
Social Skills Training
Coupled with other therapies, social skills training has been effective in improving social behaviors that result from a childs angry, defiant approach to rules. Incorporating reinforcement
strategies and rewards for appropriate behavior helps children learn to generalize positive behavior.
Social skills training, can help children learn to evaluate social situations and adjust their behavior accordingly. Metaanalyses of research on social skills has shown that the only
successful social skills training interventions are those that provide training in the child's natural
environments (home and classroom) so that generalization is built in.To accomplish this you will need your childs Individualized Education Plan (IEP) from school to includeCommunity Based Instruction using social skills training.
Medication is only recommended when the symptoms of ODD occur with other
conditions, such as ADHD, obsessive compulsive disorder (Obsessive Compulsive Disorder (OCD)), or anxiety
disorder. When stimulants are used to treat attention deficit/hyperactivity disorders, they also appear to lessen oppositional symptoms in the child. There is no medication specifically for treating
symptoms of ODD where there is no other emotional disorder. In lieu of medication, you might
wish to investigate EEG neurofeedback, a nonpharmacological intervention which is effective at teaching children to self-calm, thereby increasing their adaptability and decreasing oppositionalism that results from poor adaptability. In addition, if your child is often moody and angry, you may ask your pediatrician to explore the possibility of prescribing transcranial electrotherapy for your home. This involves the use of a
portable unit called Alpha stimulant, which generates low voltage alpha waves (the kind of waves the brain generates when it is calm and focused). Your child can wear this noninvasive devise for 20-30
minutes per day, to induce a relaxed, peaceful state without need for medication.
Practical Suggestions for Parents
Enlist others to help you: You need help on a consistent basis. This means you need to
speak with your parents, your siblings, your husbands parents and siblings, your neighbors and let them know that your child has a disorder which is difficult to control and very demanding
on you as a parent. Therefore, you need help on a regular basis from now
until your child is grown. Ask each to commit to help in some concrete fashion. This might
mean that someone watches your child every week so you can go grocery
shopping without a hassle, it may mean that grandma has the kids for dinner
every Saturday so you and your spouse can have a meal and a conversation
without interruption. It might mean that Uncle Mike takes you son for a
bike ride on Sundays after church so you and your husband can pay your
bills. You decide what you need, and ask each person in your support
network to make a specific commitment to help you. In short, do
everything you can to share the burden of parenting. This includes asking all
interested parties to learn about your childs disorder(s) and IDEA and
to participate in IEP meetings with the school district.
Set up an appropriate school program: If your child is not already classified,
make a written referral for your child to be evaluated for special education. Request a Functional Behavioral Analysis as part of the evaluation process. Once eligibility is determined, you want to
advocate for an IEP that include a Behavioral Intervention Plan with positive
behavioral supports to reduce the occurrence of oppositional and defiant behaviors. You also want this plan to stipulate that in or out of school suspensions may not be employed as a disciplinary measure with your child, and that your child may not lose recess. It is also important to have weekly counseling sessions with the school psychologist as part of your childs IEP with goals to develop relaxation and anger management skills, along with problem solving and coping mechanisms. Additionally,insist on having monthly parent training sessions in behavior management in your childs IEP so that you can carry over any effective interventions the school is employing to the home environment. Be certain that the IEP also indicates your child will be staying after school for aftercare and that a
staff member is to utilize this time to assist your child in completion of
all homework assignments and projects. This component is important because
it will eliminate a major source of conflict at home.
Finally, dont forget to make certain that the IEP includes community based instruction at
home and other locals your child frequently visits using social skills training.
Access community services:
Consider putting your child in daycare before and after school. Insist that homework is completed
in the afterschool program so that this source of conflict is eliminated from
the home environment. For weekends and holidays and summer vacations,
consider having your child participate in programs offered by Big Brother
and Big Sisters or Boy Scouts/Girl Scouts. Summer camps provide an
excellent opportunity for your child to start over with adults and
children who dont know their history of defiance and who will expect and
therefore automatically reinforce compliance. They also provide you much
needed time to self-nurture so that you will replenish your own
reserves and be better equipped to deal with your child when s/he arrives
home from camp. Dont forget to ask for help from your local religious
organization. Someone from your church or temple may be equipped
to provide some spiritual counseling for your child. This can be important
as prayers have been documented as an effective method of stress
management and anger control. Additionally, there may be someone who is
able to assist concretely by providing some much needed tutoring, or
picking up your families groceries while they pick up theirs or even
picking up.
The last step is respite foster care on a regular
basis: If your child becomes too demanding and it begins to impact on your
own physical or mental health, consider respite foster care. This might
mean your child spending one weekend a month with a foster family in order
to provide a break for you to nurture not only yourself, but also
other children in the home, and your marriage. Many parents indicate that
they would feel like complete failures if this became necessary. In
reality, this is a healthy effective way to equip yourself to handle your
childs special needs over the long haul.
Make consequences relevant to the offense: Avoid using generic consequences such as time out
or grounding. Instead, customize the consequence to the offense. For instance, if your child throws a shoe and break your favorite crystal piece. Then, assign your child an hourly wage, and have him work over the
next several (days, weeks, months) to earn the money to replace that item.
Each day when it is time to do the extra chores, give a reminder that helps the child connect the behavior to the consequence. For instance, Joey, it is time to rake the lawn to earn some more money towards paying for the crystal that broke when you choose to throw the shoe. If you child steals something, then the consequence might be a visit to the police station, witnessing some criminals in cells
and a discussion with a police officer about what happens to children who steal. If your child, lies then
the consequence might be to do a research report on the value of honesty.
Discover what your child is truly interested in:
Some children devote so much time to being disruptive that they never
develop any appropriate interest. This is another way that camps can be of
help. For instance, you might try a few sports camps, or a music camp, or
an art camp and in the process your child may discover something that
truly interests them; which can be used as a reward and a motivator during
the remainder of the year. If you havent the funds for camps, try
your local YMCA as most will offer scholarships based on financial needs.
The YMCA and Big Brothers or Sisters and Scouting all offer positive
activities for your child to be involved in during the school year along
with opportunities to interact socially with nondisabled peers who may
provide good behavioral role models. These organizations all teach values
that include respecting parents and giving back to the community, and
thereby reinforce the values you are trying to teach your child.
·
Residential Schools:
If your childs behavioral problems grow to the point that you and your childs school have difficulty dealing
with them, consider a therapeutic residential school. This can be a
win-win-win situation. It alleviates the need for your ill-equipped local
school to address your childs behavioral needs, it provides, you, your
spouse and your other children extended periods of normalcy, and it
provides your child the structure and therapy that are needed in a
situation where they can no longer alienate those closest to them.
Additionally, when your child does come home for weekends, holidays and
vacation it is always an opportunity to start off on a positive note with a
clean slate. Moreover, relationships can be fostered while your child is
at school through letters, emails, on-line photo albums and phone calls
without having to deal with day to day conflict.
Someone to talk to: Whether it is a friend, relative, friend,
pastor, or a counselor, you need to be able to talk to someone on a regular
basis; and most especially when things are going badly. Issues you may
need some help with are:
· Carving
out time for your marriage
· Nurturing siblings of your difficult
child
· Communicating your childs home and community needs to
the
IEP team
· Behavior management
techniques
· Effective advocacy within the educational
system
How to begin
dealing with your childs behavior
· Start at ground zero. Tell
your child that his/her behavior
has not been acceptable and that the whole
family is going to start over.
Develop a list of expected behaviors and
consequences for noncompliance.
Post these in a predominant spot. Then,
develop a list of your childs
responsibilities and privileges that can
be earned by completing those
responsibilities without a hassle or
reminders. Start with only essentials
being provided: bedroom, basic
food, clothing etcetera. Make it so that
your children need to earn TV
time, computer time, having friends over,
visiting others, trips to the
library or bowling alley, and extra half hour
later bedtime, and so forth.
The children in your family without
oppositional and defiant behavior will
follow the same rules and as they
are already compliant should have no
problems earning their privileges and
setting a good role model.
- Build
on the positives, not the negatives. Create ways for your child
to
experience positive feedback. This might involve having them
participate
in a formal volunteer program in the community. Or, it may be
as simple as
asking them to tutor a younger sibling in an academic area
where they have
strength and then providing plenty of praise. Creating as
many
opportunities for positive reinforcement as possible, and in so
doing
create as many opportunities as possible for your child to help those
less
fortunate than themselves. This helps combat their feelings of
entitlement
and begin to understand the perspective and needs of others. It
also
provides opportunities for you to compliment their hard work in
their
undertaking.As a general rule, each day children should
hear more
positive than negative comments about themselves.
- Use
teachable moments to your advantage. Kids with ODD would like to do
well,
but they have been prewired such that they lack the necessary
flexibility
to adapt easily to environmental demands. You can help your
child by
teaching adaptive skills. The easiest way to do this is to model
adaptive
behavior and to verbally mediate your actions. For instance, when
someone
cuts you off in the Wal-mart parking lot and steals the spot you
have been
waiting for. You can calmly drive on while saying: That
persons rude
behavior was very upsetting, so Im going to breathe
deeply to recompose
myself. Or, Im really frustrated that I didnt
receive a promotion
at work after all the extra hours I have been putting
in. I know Joe got
the promotion just because he is friends with my boss.
So, Im going to
direct the energy from my anger into looking for a new
job with more
advancement opportunities. Maybe you can help me print
copies of my resume
and search the internet for possible openings.
Involving your child in
these types of constructive actions can help your
child learn to
effectively direct their own anger energy into similar
constructive
activities. Or, you might say, Im tired and frustrated
and feel
grumpy, so Im going for a walk to refresh myself. Would you
like to
join me? Physical activity releases endorphins that improve our
moods,
so modeling physical exercise as an outlet for anger or frustration
is very
positive. You can also direct teach. For instance, if you see a
peer
tease your child, before the situation escalates you can step in and
say:
Bob, I heard you teasing Joey. Im certain that hurt his
feelings.
Now Joey may choose to ask you to go home, or he can choose to
ask you for
an apology. Joey what do you want to do? Bear in mind
though, that
oppositional children tend to respond more positively to
verbally mediated
role modeling than they do to direct teaching.
- Pick your battles. Most
children with ODD are doing quite a few things
that you dislike, but if
everything is a battle you will get nowhere. If
something is simply
annoying you might choose to ignore the behavior. For
instance, if your
child interrupts while you are on the phone you might
tell the other party.
I need to get off the phone now and Ill call you
back later. Then, when
your child requests attention appropriately. Thank
him or her for waiting
until you were free to speak. Some things you may
be willing to
occasionally negotiate on. For example, if homework is always
to be done
before friends visit; but a very good friend is visiting from
out of
town and has only this time to visit you might say to your child:
Since
Paul is a special friend and is only here for today, we will make
an
exception and let you play now and do your homework later. But, if
your
homework is not completed without hassle by 7pm, then the next time
Paul
visits, we will not make this special exception. Some things
should
never be negotiated: being disrespectful, lying, stealing or being
violent
must always meet with consistent consequences.
- Take a break from
the conflict. If you lose your cool, the child will
see it and know that
s/he has the upper hand. Learn to take time to say.
Right now, I am
very angry with you. Go to your room, while I think
about how we will deal
with this. Then, call a resource person or do
something that helps you
calm down. Later, when both spouses are present,
address the issue
jointly.
- Dont keep your childs misbehaviors a secret: When
your child has
chosen to be defiant and have a consequence doesnt hide
it. If they
cant go to the movies with Uncle Mike because they stole
something, tell
Uncle Mike the full reason. This may bring the reproach of
others to back
up your position that such behaviors are not acceptable. If
your childs
best friend may not come over because your child did not
complete his
homework, let the friend know: Joey cant play today
because he
hasnt completed his homework. You may help him with his
homework or you
may come over another day.
- Quality time: When you
have a child who is oppositional and defiant you
may feel as it all or most
of your interaction with that child are
stressful and conflict ridden. To
counter this, when you child arrives
home, make certain you have a full
half hour free of other commitments.
Devote this time to engaging in an
activity of preference with your child.
For example, your child might enjoy
Webkinz; if so play this with him. Or,
your child might like a particular
Game Boy or Nintendo Game. If so, learn
to play it and have a contest.
Or, perhaps you have a child, who likes
certain board games, then sit down
and share some pleasant time together.
It might also be time painting or
drawing, or working on a wood working
project. The activities dont
matter, as long as your child enjoys it
and you get at least a half hour a
day of uninterrupted time with your
child engaged in a positive activity
together.
Additional Advice...
· Dont take it personally.
You child may call you
mean, but they are really frustrated by their
own lack of
adaptability and are lashing out at the nearest target. When
this happens,
just tell your child that even though they are angry with
you, you love
them and will continue to do what is best for them.
·
These children are experts at pushing your buttons, so don't
let them.
Keep your composure, no matter how difficult. Do not fight with
your child.
If need be, walk away, take a bubble bath, use the Alpha stimulant,
do deep
breathing exercises. Then, when you are calm, and your child is
calm
address the issue that gave rise to the conflict.
· Give genuine
choices. Give them appropriate control when you
can. For example, Joey,
you need to clean your room today. You may do
it now and then have the
afternoon to play. Or, you can play for just two
hours and then stop to do
your room. Which do you prefer? Or, "
Joey, your teacher says your
are behind in AR reading. Do you want me to
read with you a half hour each
night at bedtime, or do you want to read a
half hour by yourself every day
before going out to play?
· Connect with what you like about
the child. Dont forget
that he or she is a child with many wonderful
features. Work on that part
of your relationship and help them remember
who they are
