Is Oppositional Defiant Disorder Real?

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 theDSM (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
  1. Often blames others for his or her mistakes or misbehavior
  2. Is often touchy or easily annoyed by others
  3. Is often angry and resentful
  4. Is often spiteful or vindictive.
  5. 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.