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ODD: An Overview and Strategies for Educators

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ODD: An Overview and Strategies for Educators

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Jones, S. H. (2018). Oppositional defiant disorder: An overview and strategies for educators. General Music Today, 31(2), 12–16. https://doi-org.easydb.angelo.edu/10.1177/1048371317708326

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Oppositional defiant disorder- An overview and Strategies for Educators

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What Teachers Should Know

Even the best-behaved students occasionally can be difficult. But kids and teens who display a continual pattern of tantrums, arguing, and angry or disruptive behavior toward teachers, parents, or other authority figures may have oppositional defiant disorder (ODD).

Students with ODD can be so uncooperative and combative that their behavior affects their ability to learn and get along with classmates and teachers. It can lead to poor school performance, anti-social behaviors, and poor impulse control.

ODD is more common in boys than girls. Signs of ODD generally develop during preschool years, and are almost always present before early teens.

Symptoms of ODD can be hard to distinguish from other mental health disorders. Children and teens with ODD may also have:

Behaviors associated with ODD can be mild, moderate, or severe and include:

negativity

being argumentative and defiant

disobedience

hostility toward authority figures

temper outbursts

angry and irritable mood

Students with ODD might need:

seating closer to the teacher to avoid disrupting other students

breaks from classroom activities when they feel overwhelmed

more time to complete assignments

to consult with a school counselor or psychologist

to visit the school nurse to take medication for coexisting conditions, such as ADHD

an individualized education program (IEP) if a learning disability is associated with their ODD

ODD treatment involves therapy, training to help build positive interactions, and sometimes medications to treat related mental health conditions.

What Teachers Can Do

It can be difficult to recognize the differences between a strong-willed or emotional student and one with ODD.

Post classroom rules and review them regularly. Have a plan in place to handle serious behavior problems. Students with ODD often are isolated and lack friends. They may be the targets of bullies or be seen as bullies.

Be sensitive to self-esteem issues. Provide feedback to your student with ODD in private, and avoid asking the student to perform difficult tasks in front of classmates. It can be helpful to praise positive behaviors, such as staying seated, not calling out, taking turns, and being respectful.

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Oppositional Defiant Disorder Factsheet (for Schools)

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Even the best-behaved students occasionally can be difficult. But kids and teens who display a continual pattern of tantrums, arguing, and angry or disruptive behavior toward teachers, parents, or other authority figures may have oppositional defiant disorder (ODD). Students with ODD can be so uncooperative and combative that their behavior affects their ability to learn and get along with classmates and teachers.

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School & studying

Being in education, at school, college or university, could be difficult as well as rewarding. For many people we spoke with, doing well in school was really important and often a big part of who they are. People talked about the risk of becoming too obsessive about school work when they were unwell; their behaviour and thoughts could spiral out of control. The social side of being in education could be challenging. Fitting in with other students could be hard, and some had been bullied in school. Being at university meant being independent and having more flexibility. Freedom could be a shock, but a starting a new chapter in life could provide positive motivation to get better and to stay well. We also spoke to people who had attended school at hospital during their inpatient treatment (for more see ' Staying in hospital').

School work & exams
Many young people described themselves as having "perfectionist" tendencies, being "driven" and "hard-working". Some said that their self-confidence mainly came from doing well at school. Being able to do some school work or sit exams even during hospital stays could be hugely important.

For many, the pressure and competitive environment of school had contributed to becoming ill or relapsing. Often the pressure came from the person themselves: it wasn't about wanting to be better than others but the best they possibly could. Exam times could get especially stressful and people described working "obsessively", especially when unwell. Zoe described how school work took over everything else: social life, relationships and hobbies. Eva had to learn to find the right balance between school work and social life because she could easily become totally absorbed in work.

Zoe became obsessive with her schoolwork. During postgraduate studies she started doing more fun...

Zoe became obsessive with her schoolwork. During postgraduate studies she started doing more fun...

I mean undergraduate level, I worked very, very hard. Especially, I mean of course everyone works hard and especially in the final year, but in the final year, again, the work really got too much to the point where I was not sleeping. You know, I would be up the crack of dawn, go into the library, stay there till evening. You know, come back at sort of ten o'clock, try and go to bed, not be able to sleep and it got too much. And in the end, I was almost it was it was there was a lot of concern and it was almost to the point where I wasn't allowed to sit my final exams.

Just 'cos I was just totally overwhelmed by the work and then when you're not sleeping I was, you know, my mood was all over the place and it just got ridiculous. Apart from that, I think though, I was always I worked harder than the average, average student. I was always, if I did go out, I would always, you know, get up. I would never lay in bed like so I, yeah, and all my friends knew very quickly, I sort of got this reputation for being this very conscientious, hard working person, which is not necessarily a bad thing, but just at points it did get, take over.

And, actually, now I'm here doing a post graduate degree things, they're still, they're not great in terms, well, no, they're fine but I do still have this reputation for working very hard. Not giving myself a break very often but it's hard in this environment, because a lot of people don't and, actually, compared to a lot of people I'm actually pretty good. And I've really worked over the last year and a half to try and incorporate other things into my life and more, and sort of trying to shift the balance away from work. Work's still very important to me but I sort of figure if I do a good day's work, nine to five thirty, I then don't have to work in the evening.

And at weekends, I usually do a bit but it's quite relaxed and so I've really I really feel like I've sort of turned a corner over the last, especially the last sort of year. And so that's good but I certainly, it is something that I'm much aware of now but if it, I could easily fall into the same traps again where I was just, I'd just work all the time.

Failing her A-levels and seeing friends move on with life made Hannah O want to get better. She...

Failing her A-levels and seeing friends move on with life made Hannah O want to get better. She...

What do you think was that sort of change in you that you wanted to start getting better?

I think I failed like the first two years of college. I just, I'd been sick, like I started making myself sick quite a lot like when my periods came back and I just couldn't take it and I just started binge eating and being sick and I just put on weight and I it was just like a horrible time.

And I failed my A levels because I was just being sick like three times a day or something. Just my body was just, I felt horrible. I felt like so unhealthy and so disgusting and then my friends started going to Uni and stuff and I just. So I went back to college and I thought, "I'll just try hard this one year."

And I did like my A levels in one year and passed and went to Uni and I think, when I started, when I started having something to work towards and just that I wanted I knew that I'd be so fed up of being ill. I was just like, exhausted and just, it was just horrible. I just wanted to be like my friends again sort of carefree as any like eighteen year old. And I wasn't and then I think that's when I just I started trying really hard with my A levels the second time round and that was when, I think that was when I got better really complete like just having something to work towards. Yeah, and something, a distraction.

Not everyone felt able to engage with their school work. They described not being bothered about school work, or missing school because they were unwell or being bullied. Georgia disliked everything about school and Andrew refused to go to school because he associated his problems with the school environment. People often struggled with moving between schools. For some, the move from primary to secondary school had been a trigger to develop the eating disorder, or they had relapsed when moving to college or university. This was because of the new environment and increased pressure but also the more informal structure of college or university. People were so used to control and rigid routine that having more free time and a flexible study arrangement could drive them to exert control over their food; they may start to restrict or purge.

Chloe got too ill to attend school. She wasn't too bothered about it because she 'hated' school.

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Chloe got too ill to attend school. She wasn't too bothered about it because she 'hated' school.

So it was it was all starting to get a bit scary. And then I had outpatient appointments for maybe like a couple of weeks but by that time I was so ill I couldn't go into school.

And like I couldn't do much. Like I used to go swimming lessons and things like that but it was just it was getting to the stage where I didn't have enough like body fat and stuff like that to keep me warm in the water and things like that. So and then the GP was like, "Well, maybe you should stop exercising just now." So it was a bit disappointing because like I never really found that exercise was something that I did try and lose weight but it was it was just like the things that I enjoy I wasn't allowed to do.

But I wasn't so fussed about not being in school because I hated it. I just felt like I was just really nervous in school and I didn't like I don't I didn't have a big group of friends of anything. I just sort of tagged along with people and I was just nervous to speak and... Just, I don't know. I didn't like school so I wasn't that bothered. I wasn't very happy there anyway.

Some had failed or underperformed in their GCSE or A-level exams because they had been too unwell. For Rob and Sam, for example, not being able to do well in exams "hindered" their future opportunities. Not being able to apply to university meant they had to find other options.

Rob couldn't sit his GCSEs so he did an Open University course then went on to music college. He...

Rob couldn't sit his GCSEs so he did an Open University course then went on to music college. He...

It, it's almost like with education you're like sort of funnelled down this route, you know this one sort of path and if and I was completely outside of that. And so there's no there's nobody there really trying to push me along. It was like sort of just floating [laughs]. But only it turned it turned out that that I found out about kind of another college actually. It's like a music college and they have a course which was which, it's kind of more academic rather than like an instrument course and I just applied for that and I thought that would be really ideal 'cos I'm interested in music. It's the equivalent of two A levels so it would be a good way to kind of progress, start to progress as well. So I just applied. They took me on the strength of my Open Uni qualification and the kind that I, the evidence that I had with my work that I had been doing and stuff.

So I got in and that's what I'm doing at the moment. I'm kind of there for another, until June or so and then but it it's really good because 'cos now I've got this world of opportunities that's opened up really and I do actually have, in my mind, like a quite like, there's a journalism course that I would be able to qualify for with, if, you know, if I pass this one. So I do actually have like this move forward and it's and it's all achievable and I feel a lot more lot more positive and like I have more direction than really now more than I ever have in my life even prior to being ill certainly. So that's been tremendously positive.

"You've got to look a certain way within schools to fit in." -Nico

Many young people we spoke with shared a sense of "not fitting in" with their peer groups or having "an alternative" outlook; they could feel isolated and lonely. They often compared themselves, or felt compared, to others and some described feeling "inferior". Some said they didn't feel comfortable in the "superficial" culture at school where they felt most people were focused on looks and popularity. Sometimes people felt self-conscious of their weight, felt over or underweight or were teased about their weight see ' The beginning of an eating disorder'.

Some had been bullied in school. Sam nearly dropped out of school after years of increasing verbal abuse. Another result of the bullying was that Sam didn't get the exam results he wanted and was not able to apply for university.

Sam was bullied in school since he was 11. Teachers had no control over it. Sam started comfort...

Sam was bullied in school since he was 11. Teachers had no control over it. Sam started comfort...

Well I guess it really began when I was 11, it was, I was in year 7 the first year of High School and from the word go you know I was bullied quite badly, mostly teasing, for lots of different reasons. It was partly because I was very clever, that was very obvious I was in the top set, I was called "swot" quite a lot, and various other words like "boffin."

And it was probably quite apparent to my peers that you know I was not conforming to the typical male stereotype. You know I didn't, wasn't interested in football, wasn't interested in girls, and wasn't interested in any of those things. And it was often assumed that I was gay. And I was called all those different names that were quite derogatory and of course that bothered me, but at the time, I didn't know what gay was, because of course the word itself is often misused. Just because I am something that's not good or un-cool, as in that is gay. So of course I had this sort of slightly odd idea about what that word was, and it wasn't the true meaning.

So it meant that you know I couldn't, and certainly at that age I didn't, you know, it wouldn't, I didn't obviously think that I fancied men, you know, so that I was too young really to sort of make those, you know realisations, and least of all that connection between the word and what, what it really meant.

So of course a lot of that over time sort of built up and it's the bullying, like a lot of bullying if often spreads, it's like a disease. You know once one bully you know gets away with it time and time again other people join in, and before you know you're getting ganged up on. You know and that was the secret of the school yard, it could be even in lessons, you know if the teacher couldn't quite control the class. So for about two years, years 7 & 8 it was just constant teasing and you know I probably just about coped with it, and then in Year 9 I think that was when everyone's hormones sort of seemed to kick in, because it seemed to, you know become more intense. The bullying was more it became almost more violent.

I remember on one occasion in Year 9 I think it was like the first geography lesson, and a bully decided to pick on me that day and I think I reacted to him by saying, "Will you please go away," or something and he said, "No," and I threw something at him because you know I was just so annoyed, and of course you know I was really beginning to not be able to cope with it, you know, I was quite anxious, it was the beginning of the school year, so I just stormed out of the lesson.

And that' s what I frequently did at that point, but where I would go, you know it was the boys' toilets, locked myself away in a cubicle because it was the only place you knew you wouldn't be found. And I don't really remember the first time but I used to sort of just comfort eat, partly from boredom but partly for comfort. And you know that used to make me feel better but sometimes you know I'd eat so much in such a short period of time you know I'd feel quite uncomfortably full. Of course there's all that bit of tension and anxiety, so that whirling in the stomach sort of feeling, and you know I really wanted to get that out. And I felt like I was going to be sick anyway.

The bullies often targeted people who already were quiet or had low self-esteem. Some had been called names referring to their weight. Craig was bullied from the age of 8 for being shy and quiet. Being singled out and bullied often knocked people's confidence even further and could have long lasting impact on their lives.

Teachers and support from school
Some had extremely supportive teachers they could trust and talk to openly whereas others found their teachers were not very supportive. Sometimes a teacher was the first person the young people confided in or who picked up on the eating problem. Suzanne was able to talk to a teacher she "adored" and Eva used to eat her lunches in her teacher's office at times when lunch breaks felt too much to cope with. The school could also support through school nurses or counselling and by offering flexibility around exams and hospital appointments during school hours.

Elizabeth said while most of her teachers were "horrible", she had a fantastic Biology Teacher...

Elizabeth said while most of her teachers were "horrible", she had a fantastic Biology Teacher...

Teachers, some teachers were amazing, other teachers were horrible. Some, yeah my form tutor was brilliant. She took me under her wing almost, and kind of cared for me. As you would do a kind of to a child almost I guess, as a daughter. I was, she was a biology teacher, I don't know if that meant she understood any better or not, but she just seemed to kind of empathise and support. Other teachers were horrible, they were like "Oh, she's not been here for a whole year, so we're just going to give her a C because," and I was a straight A student. Like I, you know, this was, before that I was like got A's in everything. And so, "Oh, we're just going to give her a C because she's not really been here. So we don't know what she's like, so we're just gonna like, we're just gonna give the average," really dismissive. Which I found really hard to deal with because it was like well they really obviously don't care, and it made me feel like an even more of an outsider.

Others were less fortunate and talked about teachers who were unaware, uninterested or incapable of stepping in to stop bullying and/or lacked understanding about eating disorders. Lack of support from the school could lead to people feeling more inadequate and angry.

Rachel said her college was 'hopeless'. Despite promising flexibility, teachers complained if she...

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Rachel said her college was 'hopeless'. Despite promising flexibility, teachers complained if she...

College was fine as far as the work was - like most anorexics I am a perfectionist and when I was trapped in anorexia, I would do homework set that day on my breaks at college to be the best I could be and also to avoid my friends.

As I got iller the work load got stressful but college was hopeless - they had said they would take the pressure off me but then started complaining when I hadn't handed one essay in after a particularly hard weekend for me.

My tutor had called me in for a meeting as a friend had gone to her concerned about me. All they did was give me information about Beat but because I was in denial about my anorexia I never used it. Other lecturers tried to make me eat lunch or informed other lecturers that I wouldn't be paying attention in classes as I hadn't eaten!

When I was at the unit, I was only allowed to go to one lesson a week, only increasing the number of lessons I went to if my weight went up. Originally college said they would give me a home tutor but when I started going to three lessons a week they said I didn't need it any more, even though I was still missing nine lessons!

I kept to the college timetable at home; did extra work and was getting excellent grades but they still complained about me not being there. They told me off for not going to English Literature even though I was further on in the set book than everyone else and I literally couldn't go to lessons as they were over lunchtime or a time when I was supposed to have an Ensure.

In March - two months before my A-Levels began - they called my Mam in for a meeting to say I had missed too much college and would fail my A-Levels. They advised me to take a gap year. My Mam disagreed as she knew I was working hard and that getting into University was my motivation to eat. So she told me to stuff the unit and college; how I would go to as many lessons as possible - I started going to 10 out of 12; revised as much as I could and ended up with 3 C's!

"It was just the change of environment, going somewhere, the fact that nobody knew. Like you could meet people, without a label - have a kind of a bit of a fresh start." -Katie

For those who went to university, there was often a complete change of lifestyle, which was both exciting and a little daunting. Moving to a new place and leaving family, home and peers behind could be "a fresh start", free from the triggers and reminders of their past experiences. They felt free to meet new people without having a label. Moving away from home was a huge "relief" for Andrew as most of his problems were connected to family relationships at home. Some people felt that leaving the daily practical and emotional support provided by their family was hard at first.

Starting university was "a changing" point for Hannah O. She wasn't burdened by the past and...

Starting university was "a changing" point for Hannah O. She wasn't burdened by the past and...

Yes, so then you stopped the outpatient treatment or anything when you went to university?

Yeah, I think that was I was that was just like the changing point in my life. It was completely new and no one knew that I'd been ill. Nobody knew.

Yeah.

Like, you know, you can just be this whole new thing like. Whereas at school I was still that girl that had missed like five months at school and I think that's what I really like about it and made new friends and just kind of become who you want to be really.

Getting a place in a top university was a big motivator for Elene to get better. For the first...

Getting a place in a top university was a big motivator for Elene to get better. For the first...

But yeah, I guess when I found out I got into [university] and I really suddenly felt like, "Oh, my God. I finally have something to lose and that all that was worth something on paper." And yeah, so I guess that kind of changed things and it just I guess what my parents like thought about me didn't really matter much anymore.

Like I live in the middle of nowhere in the holidays and like I was always trapped there like with no money and to get away and I couldn't drive and no one would drive me anywhere and trains every three hours, or two or three hours. It's better now. And I guess I felt that meant like, "Oh, in the future, like I will be dependent, independent, like I'll be able to do what I want." So yeah and then what's, yeah, I guess like so my like the whole kind of behaviour, like eating disorder behaviour really liked died down. I was about eighteen.

Going to University also meant a change in the formal support services such as GPs and mental health professionals; this could have good and bad sides. There could be a gap in counselling, for example, before seeing anyone new. Some people couldn't find a new therapist, or set up a regular contact with services. New health professionals could turn out to be great and university towns were more likely to have GPs with a special interest in eating disorders or young people's mental health issues.

University also usually meant a big change in eating routines. It could be an opportunity to leave old unhealthy eating habits behind. Young people became either solely responsible for buying and cooking their own food or some stayed in catered halls. Sharing kitchens and eating with others could be hard and some people felt uncomfortable. Katie said seeing how others ate, and their portions sizes was actually helpful in learning to eat more "normally". It could be helpful to tell housemates about their issues and if they didn't want to share foods in the fridge, for example. Living in catered halls made it easy because people didn't have to plan meals but people also felt that eating with others could be tough.

Harriet is very independent so found it easy to settle at university. Her mum said not to worry...

Harriet is very independent so found it easy to settle at university. Her mum said not to worry...

I think, in some way, my time in London helped me in terms of living away from home for such a long time. It didn't really faze me coming over. I mean, obviously, I was anxious and stuff but maybe not as much as I would have been. And I think the eating disorder somehow, strangely gave me independence because I'd been sort of independent. I always sort of chose what I ate and chose what I wanted to do, whereas some people, you know, come and they've been, their mums done everything for them, whereas I sort of personally chose to be more independent, yeah. Yeah. It's just been a case of making sure I eat enough and, you know, it's busy and I sort of find that it's sort of, well, sometimes it's easier to eat because, you know, I need the energy to concentrate and I find if I do get quite, you know, haven't eaten for a while and then try to do work it just, it's, doesn't work and I don't focus and stuff.

How have you found it practically the sort of the routine of buying food and cooking and eating? Do you find it easy to maintain or?

Buying food is okay. Sometimes I worry if I spend too much but my mum's like, "I don't care how much you spend, just as long as you're eating." And cooking has been okay. Sometimes I've sort of thought, "Oh, I can't be bothered to cook." But I've always had something sort of handy. Sharing the flat and sharing the kitchen and stuff, it's something, it's been okay but I'd don't really like people commenting on what I eat or.

Just sometimes like social food like maybe getting a pizza or if people want to get fish and chips, I find that quite anxiety provoking 'cos I like to sort of have my routine and know what I'm going to eat and I still like need to be prepared for something different.

Usually universities had more support available than schools for those who needed it. Some people had been supported by their university's disability and welfare office. Practical support could include:

*Help with time management

*Informal emotional support

*Information about other services

*The university just being aware of possible issues.

Francesca felt strange at first about getting support from the disability office but realised that an eating disorder was like any other illness and she deserved the same support as others. She was also able to apply for accommodation with private kitchen and bathroom on medical grounds. For Nikki, her time at university was "rough going". She had recently come out of hospital and didn't have the right support. She was "dead set" on doing her degree and, although it was tough, she never regretted it.

Laura was supported by her university's learning support team. Not having a predictable routine...

Laura was supported by her university's learning support team. Not having a predictable routine...

Because I'm on like a professional course I have to see Occupational Health and be cleared by them. So I could, they could quite easily ask me to leave because of everything that's gone on since being at Uni, but they're quite supportive because of how my marks had been before Christmas, because I was getting Firsts and stuff. And it's only since kind of Christmas that things have gone a bit more downhill.

But like my Tutors who are really helpful have put stuff in place like sorted out extensions and I like have sessions with the learning support team to try and keep up with my work. Because I don't do very well with not having a routine, so when I have like not very many lectures and it's really difficult for me to not struggle. Because it just gives me too much time to think about things, and I'm not very good at structuring my time. So they kind of try and help me create some sort of structure.

Francesca had weekly mentoring sessions through the University's disability office. They worked...

Francesca had weekly mentoring sessions through the University's disability office. They worked...

What does the weekly mentor mean, how does that work?

It's part of the disability scheme and they allocate it based on your need and, obviously when I had my first assessment, I was quite needy, safe to say. So I actually get allocated an hour and a half each week to go to the mentor and it's kind of up to me and her what we do, like I work with her. Any anxieties or problems that I've got I work through, like she lets me if I have a presentation to do, like I can go there and practice my presentation, she helps me work out the timetable for the week so that I can make sure I get all my work in at certain times, and she also sort of, actually really encouraged me over the last year to make sure I have social time and time for myself which I think, what else do we do? If I have any problems, she's just there to listen.

So, which is nice to know that there's someone impartial that I can go to. But yeah it's really just up to me whatever else I needed. If I need any help, she will contact other people for me, on my behalf, and help me do that, like when I had issues. This year I had to find accommodation again without friends, but she helped me do that and she helped speak to people on websites and all of that so, it's just really whatever you need.

So it's very pro-active and very involved?

Yeah, really. If there's time to that I just, she can see that I'm, I don't want to be there she'll kind of just be like, "OK, is there something I can help you with? What's up?" And sometimes I've, I just, I just don't need anything that week and she's just like, "OK well, we'll leave it at that, you've got my email." And if I ever do go upset or have any issues, she'll email me during the week before our next meeting just to check up on me. But she's nice so I do always know that she's there. That's very helpful.

Sometimes people got in touch with the university support services before they moved to university to make sure there was help available for them.

Ewan will move into adult services as he moves to university in a different town. He has already...

Ewan will move into adult services as he moves to university in a different town. He has already...

The phase between moving on from CAMHS to adult services - how is that taking place? You know is there something already changing?

Yeah there's something in place but it's more around, centred around as a safety net as opposed to a compulsory thing now. So when I'm at university and, if I'm struggling I can go there and they'll, there will be someone there to talk to me.

And how do you feel about the change?

I'm looking forward to the change in lifestyle by going to university. And having a different life and knowing different people. But I don't, am sort of feeling a bit of anticipation about the actual services because the CAMHS psychiatrist I've had has been so good so, it's going to be very hard to find someone to live up to her standard.

And do you plan to apply to the university here or somewhere else?

I have done, but it's mainly a backup choice. I'm hopefully going to do history. We've talked to University about back up support and things like that.

And they are very supportive about it.

People often found social life and meeting new people much easier at university than before. Many felt that people were more "mature" and "accepting" and they could find people they clicked with.

For more see ' Social life and public places' and ' Friends and Relationships'.

Last reviewed October 2018.

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Eating disorders (young people) - School & studying

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Being in education, at school, college or university, could be difficult as well as rewarding. For many people we spoke with, doing well in school was really important and often a big part of who they are. People talked about the risk of becoming too obsessive about school work when they were unwell; their behaviour and thoughts could spiral out of control.

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmful and Place Students At-Risk

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmful and Place Students At-Risk

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmf - American School Counselor Association (ASCA)

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All schools and communities have students who could potentially drop out of school and/or engage in destructive behaviors such as absenteeism, performing below their potential academically, substance abuse, bullying, cyberbullying, suicidal ideation, physical violence or engaging in self-harm and other destructive or dangerous behaviors.

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Miller, A. (2020). OCD is not what you think. [Clip art]. https://medium.com/amalgam/ocd-is-not-what-you-think-it-is-ee818028e79c

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmful and Place Students At-Risk

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmful and Place Students At-Risk

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The School Counselor and the Identification, Prevention and Intervention of Behaviors That Are Harmf - American School Counselor Association (ASCA)

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All schools and communities have students who could potentially drop out of school and/or engage in destructive behaviors such as absenteeism, performing below their potential academically, substance abuse, bullying, cyberbullying, suicidal ideation, physical violence or engaging in self-harm and other destructive or dangerous behaviors.

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Elementary school teacher's preferences for school-based interventions for students with emotional and behavioral problems

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Elementary school teacher's preferences for school-based interventions for students with emotional and behavioral problems

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Egan, T. E., Wymbs, F. A., Owens, J. S., Evans, S. W., Hustus, C., & Allan, D. M. (2019). Elementary school teachers’ preferences for school‐based interventions for students with emotional and behavioral problems. Psychology in the Schools, 56(10), 1633–1653. https://doi-org.easydb.angelo.edu/10.1002/pits.22294

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Elementary school teacher's preferences for school-based interventions for students with emotional and behavioral problems

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What is OCD?

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Psychiatry.org - What Is Obsessive-Compulsive Disorder?

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Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significant…

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Schizophrenia Definition
Schizophrenia is a mental disorder or illness that affects as many of 2 million Americans each year. It is a mental disorder that cannot be cured and can have severe and even disabling symptoms that can affect individuals their entire lives. Many people estimate that as many as one percent of the world population is affected by schizophrenia. Many believe that the disorder can effect men and women equally; but most would agree that men are often effected at earlier ages and often more severely than women. (Grohol, n.d.). Some others think that the numbers of people affected by Schizophrenia are closer to nearly 1 in every 100 people, as does Professor John McGrath of Queensland Centre for Mental Health Research. There is a strong believe by some that schizophrenia does occur more often in males than it does in females and that in different areas of the world the numbers of cases of schizophrenia differ. (Prevalence of, 2005). The only thing that the professional seem to agree fully on is that that is no clear cause for this disorder.

Symptoms
As is true with most mental illnesses or disorders, symptoms do not always fit exactly and can actually represent a variety of illnesses and disorders; so it is very important to rule out all possible physical problems and ailments before considering schizophrenia as a diagnosis. Also it is worth noting that many mental illnesses and disorders share common symptoms, and schizophrenia is no different in this respect. There are several symptoms associated with Schizophrenia.
* Distorted perceptions of Reality. Because schizophrenics live an existence that includes delusions and hallucinations, they often have a much skewed view of reality. They often find themselves living in their own world or reality.
* Hallucinations and Illusions. Hallucinations and illusions are very common for people suffering from schizophrenia. Hallucinations can occur by use of any sense perception, but auditory (hearing voices) is the most common for of hallucination for schizophrenics. These voices can talk to the schizophrenic, advice them, carry on regular conversations with them, and direct them to do certain things. An Illusions is a real sensory stimulus, but one that the schizophrenic individual interrupts wrongly.
* Delusions. A delusion is considered a false belief that has no rational basis. A person with schizophrenia may have feeling of being persecuted or spied upon.
* Disordered thinking. The schizophrenic is often not able to think clearly or "think straight".
* Emotional Expression. Those suffering from schizophrenia often show little to no emotion and even go as far as changing their speech patterns to expression filled speech to a monotone flat speech.
* Normal versus Abnormal degrees. Though everyone that is considered normal may exhibit some of the symptoms listed above some of the time; schizophrenics exhibits at least 2 or more of the symptoms in a more chronic or persistent manner. (Grohol, n.d.)

Types of Schizophrenia
There different types of sub-categories of schizophrenia. All of the sub-categories of schizophrenia are defined and recognized by their main characteristic or symptoms.
* Paranoid Schizophrenia. The main symptoms that are exhibited in this sub-category are feeling of persecution or conspiracy and auditory hallucinations.
* Disorganized Subtype. This sub-category is characterized with severe inability to organize and arrange daily living activities such as bathing, dressing, and eating. Hallucinations and delusions are usually less seen in this sub-category.
* Catatonic Subtype. This sub-category is one of the most severe degrees of schizophrenia. An example of the sub-category might be a person lying in the fatal position and able to respond to any stimulus. This state of schizophrenia can also include repetitive and meaningless sounds and movements though. In other words, the person can be void of any real communication but still make mimicking sounds or movements mocking those people around.
* Undifferentiated subtype. This sub-category is used for individuals with a diagnosis of schizophrenia, but that do not fit clearly into one of the other sub-categories. It is a sort of "catch all" sub-category.
* Residual subtype. This sub-category refers to individuals with a schizophrenic diagnosis, but that are not currently exhibiting any of the severe symptoms associated with the illness. These could be persons on medication or persons with a period of a type of remission or rather absence of the more severe symptoms. (Bengtson, 2001).

Treatment
As with most mental illnesses and disorders, schizophrenics benefit from a variety of treatments and medications. There seems to be two main issues to first address when caring for someone with schizophrenia and those are; make sure the person is taking their medication regularly and try to provide a safe and secure home environment. Those are just the beginning steps and there are more specific treatments that are available.

In all cases of schizophrenia, antipsychotic medications are almost always utilized. Some of the older medications have been available since the 1950's. These drugs; Thorazine, Haldol, Prolixin, Navane, and others were referred to as "neuroleptics" because they caused neurological side effects and had little effect on the emotional expressiveness of the patients. Since 1989 a new series of medications have been introduced including; Clozaril, Risperdal, Zyprexa, Abilify, and some others. These medication generally take two to four weeks to really take effect and have fewer side effects neurologically, but they all do still have some and varied side effects. It may take time to adjust the medication to obtain the correct dosage for each individual. One major draw back to these new medications is that failure to use them or irregular use can cause the schizophrenic individual to relapse more quickly. Still with all of the side effects and problems, antipsychotic medications are required for most schizophrenic patients.

Schizophrenics often have problems with daily living skills, relationships, communication skills and motivation. For these reasons it is almost imperative that schizophrenics get some type of psychosocial assistance. Sessions with psychologists or psychiatrists are very important to these patients' social growth. This is even more so important since the majority of cases begin at the early teen ages when social growth is so important. Family counseling with the patient in a group setting is also important. Between medications and proper counseling, most schizophrenics are able to live near normal lives. (Schizophrenia, 2006).

Educating Individuals with Schizophrenia
To this point we have discussed what people diagnosed with schizophrenia can do to help themselves, and even what family and relations can do to help; but there is still the issue of how to educate these individuals in our classrooms. There are several good suggestions as to how educators can address the problems faced with teaching students with schizophrenia. The first and foremost important issue for the educator placed in this position is to be well educated about the illness. Be ware of available treatments, causes, and symptoms so that you can discuss intelligently with parents or students issues concerning education. Reduce stress in the room as much as possible. Work with the student with schizophrenia to help them set realistic academic and social goals. Establish regular meetings with the family or student to discuss issues, problems, or successes. As much as possible, encourage participation and interaction between the student with the illness and other students. (Basic facts, 2001).

Accommodations and Modifications
With many disorders, disabilities, and illnesses there can be a variety of problems and learning problems associated with the person. Many schizophrenics can have learning disabilities in connection with their mental disorders. Addressing accommodations and modifications for individuals with schizophrenia is as individual as each person. There are many accommodations that can be used to make the schizophrenic's academic experience a positive one.

Stress seems to be one thing that can worsen the schizophrenic's chances for success. Relieving stress from the environment is one thing that should be used. Allowing the student to have a quiet secluded place to complete assignments and tests is one way to provide the student with a stress free environment. Internet courses are also a way for these students to be able to complete courses in a safe and stress free environment. The main accommodation that can be provided is priority registration. With priority registration students can choose times and teachers that will best fit into their routine and fit their needs. These are just a very few accommodations that are readily available for these students.

Schizophrenia is an illness that affects many Americans and people world wide. It is an illness that can be disabling if not treated appropriately; but can be just a minor hindrance if treated properly and addressed early. With the number of cases growing and with the prime time for onset of schizophrenia being generally early teens and early twenties, school age students are greatly affected. It becomes important for educators to become more aware of the disease and more aware of how to address this illness and the students that have it.

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Teaching and Understanding Students with Schizophrenia

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Schizophrenia Definition Schizophrenia is a mental disorder or illness that affects as many of 2 million Americans each year. It is a mental disorder that cannot be cured and can have severe and even disabling symptoms that can affect individuals their entire lives.

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How teachers and coaches can help

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Students who have participated in sports tend to experience positive effects such as healthier lifestyles, enhanced skills in teamwork, improved discipline and decision-making skills [1]. However, can a coach or teacher play a key roll in eating disorder prevention?

Sports environments, however, can increase the risk of eating disorders among some students. Coaches and teachers are in a unique position to help identify and prevent eating disorders and other disordered behaviors.

Eating disorders primarily fall into three categories, Anorexia Nervosa, Bulimia Nervosa, and Binge Eating Disorder. For these disorders to be diagnosed, they should cause significant occupational and academic impairments, impair physical and psychological functioning and show a persistent disturbance in eating patterns.

Athletes at Risk

Students athletes seem to be at a higher risk because eating disorders know no bounds within a sport. It can affect anyone, of any age, in any sport. However, it does typically affect more females than males [1].

Lean sports such as running, swimming, wrestling, etc. and sports that are judged on appearances such as figure skating, gymnastics, etc. tend to have higher rates of eating disorders, but no sport is immune to an eating disorder.

Genetics can also play a role in the development of eating disorders. There are strong indicators of genetic tendencies for eating disorders in epidemiological research, and family and twin studies have found in heritability estimates that there is a 76% higher chance to develop anorexia and 83% higher chance to develop bulimia [1].

Socio-cultural factors also play a role in developing an eating disorder. For example, if you are in a culture that focuses on diets and exercise or appearance, the odds of developing disordered eating habits increase.

Relationships are Pivotal for Eating Disorder Prevention

The relationship of a coach with an athlete can be especially important when trying to prevent an eating disorder. The athlete is influenced by the coach's motivation, their body image, their relationship with the team, the training, their competitiveness, etc.

Athletes and coaches spend a significant amount of time together during the week, especially if the coach is also one of the athlete's teachers. The coach or teacher can have a substantial influence on an athlete's beliefs, perceptions, and behaviors.

The relationship between motivation, conflict, and performance has also been shown to increase or decrease disordered eating in athletes [1].

If the conflict is high between the coach and athlete, and there is little support then typically the athlete may begin to show signs of disordered eating.

Additionally, if there is a performance-centered or judgment based environment, there is often a higher rate of disordered eating among athletes.

Thin Equals Fast or Does It

The perception of the 'thin body ideal' is also another risk factor for eating disorders among athletes. It is often a misperception among sports teams that being thin, or the right body shape will increase sports performance.

Also, there is frequently the expectation to look a specific way because the athlete is in a particular sport. The wrestler's body has to be below his/her ideal weight class, the dancer's or cheerleader's body has to be this preconceived small shape, the gymnast's body has to be ..., the swimmer's body has to be ..., etc. This can create a distorted body image and disordered eating patterns in the athlete as they strive for 'perfect' unrealistic expectations.

Dieting is What Athletes Do

Dieting and excessive training can be seen as normal in the athletic environment. Many athletes play several different sports and therefore they are in various year-round training programs.

Depending on the sport, athletes will often follow different dieting guidelines, and this is considered as a standard way of living. These behaviors often can be misperceived by trainers or coaches as athletic behaviors, but these actions can often be a form of disordered eating.

Mindfulness Practice in Middle School

One school in North Carolina works on practicing mindful eating with middle schoolers. At this school, for one class time during the week these students work on breathing practices, how to recognize satiety and hunger signals, and what food texture and tastes are like [2].

According to researchers at Kenyon College, engaging in prevention programs like mindful eating can prevent people from developing eating disorders [2].

Middle school programs that incorporate mindfulness also work to integrate reframing techniques to help youth reframe their thoughts with the use of dietetics and food science teachers.

Some schools bring in short-term prevention programs or leadership training such as The Body Positive, Girls on the Run and Girls in the Know that explore healthy lifestyles, body image, and self-care education.

These programs are often led by professional therapists, dietitians, and physicians in local communities that volunteer their time to these organizations. Other programs have guest speakers who are recovering from an eating disorder and share their personal story.

Prevention Is Possible

Working on changing the social environment through educational awareness of disordered eating, unhealthy eating patterns, obsessive exercise, etc. can help prevent eating disorders.

Another way to prevent unhealthy social atmospheres is to change the conversations from performance and appearance driven to team and quality driven.

When coaches and teachers start to focus on the team or class as a whole, talents of the person, as well as performance, it enhances the student's or athlete's self-confidence and self-worth.

Inviting dieticians to talk at schools on a regular basis about nourishment for the athlete's body, mindful eating practices, and self-care are important for all students regardless of the age or if they are in athletics.

Being able to have the student and athlete focus all of their senses on how their body is feeling, what emotions they are sensing, and how their food tastes is a great tool to use in preventing disordered eating patterns.

Engaging a school counselor or a therapist to work with a student in school or on the team or the team as a whole can help with prevention efforts. School therapists can offer educational sessions on healthy versus unhealthy eating behaviors, and provide one-on-one counseling.

Coaches and teachers can play a major role in helping a student-athlete become aware of school resources, knowing what to do when an athlete is struggling, and knowing how to support that person is important in preventing eating disorders.
About the Author: Libby Lyons is a Licensed Clinical Social Worker and Certified Eating Disorder Specialist (CEDS). Libby has been practicing in the field of eating disorders, addictions, depression, anxiety and other comorbid issues in various agencies. Libby has previously worked as a contractor for the United States Air Force Domestic Violence Program, Saint Louis University Student Health and Counseling, Saint Louis Behavioral Medicine Institute Eating Disorders Program, and has been in Private Practice. Libby currently works as a counselor at Fontbonne University and is an Adjunct Professor at Saint Louis University, and is a contributing author for Addiction Hope and Eating Disorder Hope. Libby lives in the St. Louis area with her husband and two daughters. She enjoys spending time with her family, running, and watching movies. References:
[1] Thompson, R. (n.d.). Mind, Body and Sport: Eating Disorders. Retrieved January 18, 2018, from http://www.ncaa.org/sport-science-institute/mind-body-and-sport-eating-disorders
[2] Fraga, J. (n.d.). How schools are using 'mindful eating' to help prevent eating disorders. Retrieved January 18, 2018, from https://namimc.org/schools-using-mindful-eating-help-prevent-eating-disorders/
The opinions and views of our guest contributors, are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals. We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help. Published on March 22, 2018.

Published onEatingDisorderHope.com
Tagged as: prevention, Athletics, School

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How Can Teachers & Coaches Help with Eating Disorder Prevention?

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Students who have participated in sports tend to experience positive effects such as healthier lifestyles, enhanced skills in teamwork, improved discipline and decision-making skills [1]. However, can a coach or teacher play a key roll in eating disorder prevention? Sports environments, however, can increase the risk of eating disorders among some students.

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Centers for Disease Control and Prevention

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Children with attention-deficit/hyperactivity disorder (ADHD) experience more obstacles in their path to success than the average student. The symptoms of ADHD, such as inability to pay attention, difficulty sitting still, and difficulty controlling impulses, can make it hard for children with this diagnosis to do well in school.

To meet the needs of children with ADHD, schools may offer

ADHD treatments, such as behavioral classroom management or organizational training;

Special education services; or

Accommodations to lessen the effect of ADHD on their learning.

Classroom Treatment Strategies for ADHD Students

There are some school-based management strategies shown to be effective for ADHD students: behavioral classroom management and organizational training.

The behavioral classroom management approach encourages a student's positive behaviors in the classroom, through a reward systems or a daily report card, and discourages their negative behaviors. This teacher-led approach has been shown to influence student behavior in a constructive manner, increasing academic engagement. Although tested mostly in elementary schools, behavioral classroom management has been shown to work students of all ages.

Organizational training teaches children time management, planning skills, and ways to keep school materials organized in order to optimize student learning and reduce distractions. This management strategy has been tested with children and adolescents.

These two management strategies require trained staff-including teachers, counselors, or school psychologists-follow a specific plan to teach and support positive behavior.

The American Academy of Pediatrics (AAP) recommends that the school environment, program, or placement is a part of any ADHD treatment plan. AAP also recommends teacher-administered behavior therapy as a treatment for school-aged children with ADHD. You can talk to your child's healthcare provider and teachers about working together to support your child.

Special Education Services and Accommodations

Most children with ADHD receive some school services, such as special education services and accommodations. There are two laws that govern special services and accommodations for children with disabilities:

The Individuals with Disabilities Education Act (IDEA)

Section 504 of the Rehabilitation Act of 1973

The support a child with ADHD receives at school will depend on if they meet the eligibility requirements for one of two federal plans funded by IDEA and Section 504: an individualized education program (IEP) or a 504 Plan.

What are the main differences between the two Plans?

IEPs provide individualized special education services to meet the unique needs of the child.

A 504 Plan provides services and changes to the learning environment to meet the needs of the child as adequately as other students.
Learn more about IEP and 504 Plans [PDF - 2.75 MB]
Accommodations

IEP and 504 Plans can offer accommodations for students to help them manage their ADHD, including:

Extra time on tests;

Instruction and assignments tailored to the child;

Positive reinforcement and feedback;

Using technology to assist with tasks;

Allowing breaks or time to move around;

Changes to the environment to limit distraction; and

Extra help with staying organized.

There is limited information about which types of accommodations are effective for children with ADHD. However, there is evidence that setting clear expectations, providing immediate positive feedback, and communicating daily with parents through a daily report card can help.

What Teachers Can Do To Help

For teachers, helping children manage their ADHD symptoms can present a challenge. Most children with ADHD are not enrolled in special education classes, but do need extra assistance on a daily basis. The National Resource Center on ADHD provides information for teachers from experts on how to help students with ADHD.

Here are some tips for classroom success.

Communication

Give frequent feedback and attention to positive behavior;

Be sensitive to the influence of ADHD on emotions, such as self-esteem issues or difficulty regulating feelings;

Provide extra warnings before transitions and changes in routines; and

Understand that children with ADHD may become deeply absorbed in activities that interest them (hyper-focus) and may need extra assistance shifting their attention.

Assignments and Tasks

Make assignments clear-check with the student to see if they understand what they need to do;

Provide choices to show mastery (for example, let the student choose among written essay, oral report, online quiz, or hands-on project;

Make sure assignments are not long and repetitive. Shorter assignments that provide a little challenge without being too hard may work well;

Allow breaks-for children with ADHD, paying attention takes extra effort and can be very tiring;

Allow time to move and exercise;

Minimize distractions in the classroom; and

Use organizational tools, such as a homework folder, to limit the number of things the child has to track.

Develop a Plan That Fits the Child

Observe and talk with the student about what helps or distracts them (for example, fidget tools, limiting eye contact when listening, background music, or moving while learning can be beneficial or distracting depending on the child);

Communicate with parents on a regular basis; and

Involve the school counselor or psychologist.

Close collaboration between the school, parents, and healthcare providers will help ensure the child gets the right support.

Parent Education and Support

CDC funds the National Resource Center on ADHD (NRC), a program of Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The NRC provides resources, information, and advice for parents on how to help their child. Learn more about their services.

How to best advocate for your child

Understand your child's diagnosis, how it impacts their education, and what can be done at home to help.

Understand your child's IEP. If you have questions, don't be afraid to ask.

Speak with your child's teacher.

When possible, obtain written documentation from teachers, administrators, or other professionals working with your child.

Know your rights.

Play an active role in preparing your child's IEP or 504 Plan.

Keep careful records, including written documentation, communication between home and school, progress reports, and evaluations.

Try to maintain a good working relationship with the school while being a strong advocate for your child.

Communicate any concerns you may have about your child's progress or IEP or 504 Plan.

Encourage your child every day, and work with your child to create a system to help with homework and other school projects.

What every parent should know

More Information

Reference

1. Evans S, Owens J, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology 2014;43(4):527-551 [Read overview]

2. DuPaul GJ, Chronis-Tuscano A, Danielson ML, Visser SN. Predictors of receipt of school services in a national sample of youth with ADHD. Journal of Attention Disorders Published online December 10, 2018. [Read summary]

3. Harrison JR, Bunford N, Evans SW, Owens JS. Educational accommodations for students with behavioral challenges: A systematic review of the literature. Review of Educational Research 2013;83(4):551-97.

4. Moore DA, Russell AE, Matthews J, Ford TJ, Rogers M, Ukoumunne OC, et al. School-based interventions for attention-deficit/hyperactivity disorder: A systematic review with multiple synthesis methods. Review of Education. Published online October 18, 2018.

5. https://chadd.org/for-parents/individuals-with-disabilities-education-act/

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To meet the needs of children with ADHD, schools may offer ADHD treatments, special education services, or accommodations to lessen the effect of ADHD on their learning.

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Oppositional Defiant Disorder: An overview and strategies for educators

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Oppositional Defiant Disorder: An overview and strategies for educators

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Jones, S. H. (2018). Oppositional Defiant Disorder: An Overview and Strategies for Educators. General Music Today, 31(2), 12–16. https://doi-org.easydb.angelo.edu/10.1177/1048371317708326

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Oppositional defiant disorder- An overview and Strategies for Educators

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Huberty, T. (2010). Depression: Supporting students at school. National Association of School Psychologists.

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The Effects of Math Anxiety on Math Achievement in Fifth Grade Studetns and the Implications for School Counselors

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Exposure to mass disaster and probable panic disorder among children in NYC

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Children with anorexia are obsessed with their body weight and often are afraid of gaining weight. Children's Health℠ is home to an expert team that specializes in helping children and teens overcome anorexia and other eating disorders. We create a treatment and counseling plan that's tailored to your child's - and your family's - needs, so you can get back to leading healthy, happy lives.

What is Pediatric Anorexia Nervosa?

Children with anorexia typically eat very little and severely limit the types of food they eat. They may also limit the types and quantity of fluids they drink. Usually they are below normal weight and very thin for their age. But many children with eating disorders also have a normal body weight.

Eating disorders like anorexia start in the brain. The disorder affects how a child thinks and behaves toward food. For example, a child with anorexia may believe they are overweight, even though they are actually normal weight or even underweight.

These may include:

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Anorexia in Kids - Symptoms and Treatment - Children's Health

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Children with anorexia are obsessed with their body weight and often are afraid of gaining weight. Children's Health℠ is home to an expert team that specializes in helping children and teens overcome anorexia and other eating disorders.

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Overview

Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling. However, effective treatments are available. When delivered in a timely, coordinated, and sustained manner, treatment can help affected individuals to engage in school or work, achieve independence, and enjoy personal relationships.

Onset and Symptoms

Risk Factors

Treatments and Therapies

Finding Help

Join a Study

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Schizophrenia is a serious mental illness that affects how a person thinks, feels, and behaves. People with schizophrenia may seem like they have lost touch with reality, which causes significant distress for the individual, their family members, and friends. If left untreated, the symptoms of schizophrenia can be persistent and disabling.

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Can school counselors deliver cognitive-behavioral treatment for SAD

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Is it a modification or is it an accommodation(1)