risk and resilience emotional/behavioural disorders conduct disorder oppositional defiant disorder...
TRANSCRIPT
Risk and resilience
Emotional/Behavioural DisordersConduct disorder
Oppositional defiant disorderAnxiety disorders
Exercise
Think of a student who struggled with behaviour more than any other student you know
Write down a description of some features of their behaviour
Oppositional Defiant Disorder
Pattern lasting 6 months that includes 4 or more of the following:
often loses temper
Often argues with adults
Often actively defies or refuses to comply with adults requests or rules
Often deliberately annoys people
Often blames others for his/her mistakes/misbehaviour
Is often touchy or easily annoyed by others
Is often angry or resentful
Is often spiteful or vindictive
Causes impairment in social/academic functioning
Conduct Disorder
Pattern lasting 12 months that includes at least 3 of the following in last 12 months and 1 in last 6 months:
Aggression to people and animals (i.e., used weapon, initiates fights, physically cruel to animals/people, mugging, forced sexual activity)
Destruction of property (i.e., deliberate fire setting, other)
Deceitfulness or theft (i.e., broken into someone's home, building, or car, often lies, stolen items)
Serious violation of rules (<13 years: stay out past curfew, truant from school; run away from home overnight at least twice.
Causes impairment in social/academic functioning
Prevalence
Oppositional Defiant Disorder: 3% Conduct Disorder: 5% Comorbidity:
50% of children with ODD/CD also have ADD.
Often children with ODD/CD also have learning disabilities.
Internalizing disorders (anxiety, depression) occur in children with ODD/CD at above-chance rates.
Risk Factors Individual factors (i.e., difficult temperament,
hyperactivity, aggression, low intelligence)
Family factors (i.e., parental antisocial or delinquent behaviours, maternal depression, parental substance abuse)
Parental child rearing practices (i.e., neglect, physical punishment, poor communication, teenage motherhood, single parenthood, low SES)
School factors (i.e, poor academics, old for grade, weak bonding, low motivation, low aspirations, poorly organized schools)
Peer factors (i.e., association with deviant peer/sibling, peer rejection
Neighbourhood factors (i.e., poverty, availability of weapons/drugs)
Resilience
Positive psychology: emphasizes the importance of using the scientific method to determine how things go right.
Emmy Werner Longitudinal study following 698 children
from the time they were 1 year old until they were 30
2/3s of at-risk participants developed learning or behaviour problems by age 10 or had delinquency records and/or mental health problems by age 18.
1/3 grew into competent, confident, and caring adults
Protective factors in the individual
Infancy Temperament (active, affectionate, cuddly,
good-natured, easy to deal with) Advanced language and motor development Advanced self-help
Age 10 Good problem solving skills Better readers Special talent Helped others
Protective factors in the family
Establish a bond with one competent, emotionally stable person who was sensitive to their needs
Religious beliefs providing stability and meaning Resilient boys
Structure and rules, male model, encouragement, emotional expressiveness
Resilient girls Emphasis on independence, reliable
support from female caregiver
Protective factors in the community
Rely on elders and peers for emotional support
Teacher, neighbours, elders, parents of partners, youth leaders, ministers, etc...
Sought counsel and support during crisis Opening of opportunities
Adult high schools, armed forces, marriage to a stable partner, conversion to a religion that demanded active participation, recovery from life-threatening illness or accident
School related protective factors
Schools as a Setting for Promoting Positive Mental Health: Joint Consortium for School Health
Method: (1) literature review, (2) Interviews with key informants (school health leaders and services providers), (3) analyzing convergent practices.
Findings: Social and Physical environment Teaching and learning Partnerships and Services Healthy School Policies
Exercise
You are at a Principals Leadership conference and you are trying to determine how to support students with emotional/behavioural difficulties. How would you structure the Social and Physical Environment to support mental health.
Social and Physical EnvironmentPhysically safe environment
well organized emergency plans, monitoring, school-wide positive behavioural plans, data collection.
Emotional safety learn names, ensure connection for at-risk
students, review behavioural expectations and practice specific behaviours skills/routines, model respectful behaviour, use restorative processes)
Implement school-wide programs that emphasize social and emotional learning
Social skills, conflict resolution, cooperation, emotional regulation
Exercise
You are at a Principals Leadership conference and you are trying to determine how to support students with emotional/behavioural difficulties. How would you structure teaching and learning to support mental health.
Teaching and Learning
Differentiation techniques
Structures and good instructional practices (see previous class materials)
Culturally relevant practices
Present multiple perspectives, share culturally relevant traditions, use multicultural literature
Cooperative Methods Autonomy supportive teaching
Effective listening, validating perspectives, explaining value and rationale for routines, active learning, recognition
Strength-based Approaches
Exercise
You are at a Principals Leadership conference and you are trying to determine how to support students with emotional/behavioural difficulties. How would you structure partnerships and services to support mental health.
Partnerships and Services
Sustained family contact and communication
Adult-student mentorships Partnerships with family and youth-serving
agencies (Boys and girls club/Big brother/sister)
School and community-wide mobilization activities
Forums for community issues Involve students in problem-solving and
action
Exercise
You are at a Principals Leadership conference and you are trying to determine how to support students with emotional/behavioural difficulties. What kind of School Policies could you implement to support mental health.
Healthy School Policies
Effective Leadership
High standards and expectations, upholding rules pertaining to respect, fair and equitable rules, social and emotional learning goals to School Improvement plans
Policies for inclusion Discipline policies that restore and connect
Individual problem-solving, restitution, behavioural contracts, solution focused, relationship development
Professional Development opportunities Shared policies that ensure collaboration
Exercise
Think about a child/student you know who is very anxious.
Write down dome symptoms of their anxiety.
Anxiety Disorders The DSM-IV lists 9 different anxiety disorders all of
which share anxiety as predominant feature, expressed through cognitive, behavioural, and physiological reactions (Prevalence = 10%)
Separation anxiety disorder Panic disorder Agoraphobia (fear/avoidance of anxiety) Generalized anxiety disorder Social phobia Specific phobia Obsessive compulsive disorder Post-traumatic stress disorder Acute stress disorder
Generalized Anxiety Disorder
A. Excessive anxiety and worry, occurring more days than not for at least 6 months about a number of events/activities.
B. Anxiety/worry associated with at least 3 of the following physiological symptoms:
Restlessness
Fatigue
Difficulty concentrating
Irritability
Muscle tension
Sleep disturbance C. The anxiety/worry/physical symptoms cause impairment in
important areas of functioning (i.e., school, social, home)
Core features
Most common worries: Tests/grades, natural disasters, being
physically attacked, future school performance, being bullied or excluded by peers.
Most common symptoms: Headaches, stomachaches, muscle
tension, sweating, trembling
Function of anxiety
Adaptive function Alert individual to novel/threatening
situation Individual decides whether to
confront/avoid (fight/flight).
Difference between functional and dysfunctional anxietyFunctional Anxiety Dysfunctional Anxiety
Child becomes experienced in anxious arousal, resultant habituation, and abatement of sensations Extent of worries are in line with likelihood of event.
Anxiety doesn't abate Causes pervasive fear and avoidance Interferes with child's daily functioning. Worries about future events as though they are likely to occur even when it is highly unlikely
Remediation
Cognitive-Behavioural therapy Exercise
Look at materials that I have handed out. Identify what steps have been taken to help the student manage his/her anxiety.
Step#1: Becoming aware of worry
Worry spiral (catastrophic thinking) Real worries vs. Future worries Triggers? Intolerance of uncertainty Scanning for threat The tricky brain
Step#2: Strategies
Healthy routine Thought stopping Deep breathing – meditative plan Changing frame of mind (I can do) Create plan of action/practice/role play Organizing/prioritizing – give time guidelines Setting goals to become more tolerant of uncertainty
over time Communicate stress Predicting what will make you stressed – develop
plan
Exercise
Create a flow chart where you: Raise your students awareness of their
pattern of worry Identify strategies that help them