Parent Managment Training

Conduct disorder affects children and adolescents, so it is important to focus on the particular age of a child when searching for treatment options. Many teachers and psychologists agree that in order for treatment to be successful, for both children and adolescents, the child’s family needs to be closely involved in the process. By having parents involved in the treatment, they can learn different techniques and strategies to use with their child to help manage the problem behavior. It has been stated multiple times in different research articles that the parents actually need some sort of treatment themselves because they too have been suffering from the disorder and the chaos it creates amongst a family. Treatment options can be either medication, therapy, or both. The most successful form of treatment is when medication is combined with therapy, known as cognitive behavioral therapy. The medication and type of therapy vary depending on the severity of the disorder as well as what other underlying disorder a child may have such as ADHD or depression. Another form of treatment that I came across was Parent Management Training (PMT). PMT is a source of treatment that actually has the parents BE the treatment. The parents are trained to modify their children’s behavior in the home based on what type of symptoms or aggressive tendencies the child has. PMT concentrates on reinforcement and stays far away from negative reinforcement which is said to “offset the stimulus contingent upon the emission nor omission of the target response” and the negative reinforcement suggested in this statement are ineffective strategies such as nagging, yelling, or requiring adverse behavior until a child’s behavior improves. The following power point covers the broad topic of PMT and there is a vast amount of valuable information included http://www.fordham.edu/images/undergraduate/psychology/all%20overheads/tryon/First%20Year/spring%20cts/Psychosocial%20Treatments%20for%20Conduct%20Disorder-PDF.pdf

PMT is becoming more popular amongst teachers and therapists because of the proven effectiveness it has on children with conduct disorder. I found out that many school districts have had webinars and meetings about PMT and how to relay this information to parents. There is a hotline number parents and teachers can call 1 (877) 457-5123 and there are even classes being offered to teachers covering the topic:

other psychiatric disorders closely related...

As you can see from the bar graph above, common psychiatric disorders are often related to conduct disorder. This goes to show just how serious this disorder is and how it can effect so many children. Almost every single disorder on the bar graph contains subjects with at least half having been diagnosed with conduct disorder. This is why when children are diagnosed and TREATED for conditions such as ADHD or major depression, their conduct disorder behavior also decreases because these psychiatric conditions are so closely related - at least 70% of the cases from this particular study.

Teachers helping families..

Teachers can play an important roll in diagnosing children with different disorders. Teachers see children for a large majority of the week and also see children in a different environment than their parents. As a teacher, it is important to provide families with plenty of resources that will help them understand and cope with their child’s disorder. I found a video document and brochure that a teacher could provide families with children with conduct disorder that could help them decide what treatment path to take to help their child overcome their disorder. Here is the video link: http://www.youtube.com/watch?v=x0MaaU-MM0U And here is the brochure with numbers and information provided: http://www.gulfportmemorial.com/workfiles/memorialnews/HYConductDisorder.pdf

teaching students with conduct disorder

Students with conduct disorder are at risk for academic failure because of the seriousness of the disorder. I discovered that many students with conduct disorder are not placed in a general education classroom. These students react to situations better, and in turn are able to learn more, when they are in classrooms with high staff/student ratios, 1-to-1 situations, or self-contained programs when there is plenty of structure and the expectations of the students are clearly defined. The goal of putting students in this type of environment is to teach them how to portray socially acceptable behavior. This is also the time when most students are receiving some sort of treatment outside of the school such as counseling which will also help them with their behavior. I learned that 1/3 of students with conduct disorder are also depressed, and as soon as they start getting the treatment they need for depression, their behavior greatly improves. Besides depression, there are other common disorders that usually go hand in hand with conduct disorder such as OCD and ADHD. These disorders can also be treated and once treatment begins, an immediate change can usually be seen in the child if they have been properly diagnosed and are receiving the proper treatment. If and when a student’s behavior improves, this is when they are allowed back into a general education classroom.

After realizing that I may have students with a severe conduct disorder in my classroom, I decided to find out what the best steps are to take in order to ensure the learning and safety of this child and the other students in my class. If conduct disorder has already been diagnosed, one of the first approaches to take is to discuss the situation with the parents. It is important to find out where they are coming from and what their views of the situation are. I should also try to get them involved with their student’s learning and development if they aren’t already. Students with conduct disorder don’t respond well to orders such as “You will do this…” or “Now you must…” so I would try to stay away from this type of instruction and would give them a choice instead. This theory was created by Dr. William Glasser and it is referred to as “choice theory” which I have valued for many years. I worked in a daycare with toddlers and preschoolers and the choice theory was incorporated at this daycare. The students responded very well to this theory. The ten axioms of choice theory are:

1.     The only person whose behavior we can control is our own.

2.     All we can give another person is information.

3.     All long-lasting psychological problems are relationship problems.

4.     The problem relationship is always part of our present life.

5.     What happened in the past has everything to do with what we are today, but we can only satisfy our basic needs right now and plan to continue satisfying them in the future.

6.     We can only satisfy our needs by satisfying the pictures in our Quality World.

7.     All we do is behave.

8.     All behavior is Total Behavior and is made up of four components: acting, thinking, feeling and physiology.

9.     All Total Behavior is chosen, but we only have direct control over the acting and thinking components. We can only control our feeling and physiology indirectly through how we choose to act and think

10.   All Total Behavior is designated by verbs and named by the part that is the most recognizable.

By considering these axioms, a teacher can improve the responsiveness of a student with conduct disorder. I personally don’t like being told what to do and I never have. I respond much better when I have a choice and I always work harder and am more determined to do something when I feel like I had a say in it. I can understand why these students would need a teacher who responds to them strictly, yet not like a dictator. I understand that the students must learn to listen to what we say, but I feel like it is part of the teacher’s responsibility to determine how different students respond best and to enforce effective classroom management. Dr. William Glasser has a book about choice theory which is displayed below:

Video about Conduct Disorder

I came across this video about conduct disorder if you are interested - it is a short clip that covers the topic more specifically and has a great deal of information provided by Peter Wong (Professional Clear Education Specialist)

http://www.videojug.com/interview/conduct-disorders-and-education

Conduct Disorder

As previously mentioned, conduct disorder is a psychiatric problem that affects children and adolescents. It is also the most common psychiatric problem diagnosed amongst children. The American Psychiatric Association states that conduct disorders are different from other psychiatric disorders based on the following criteria: “persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated” (2000). I wanted to find out what the most common signs of conduct disorder were for elementary level children and read several articles about the disorder to do so. Many articles spoke about the common signs of the disorder in adolescents, but I will only mention the signs that affect younger children. The common signs that I found are:

-deliberate property damage or destruction

-persistent lying to avoid consequences or to gain privileges

-limited interpersonal skills

-little to no friends

-low self esteem, however they portray a high self esteem on the outside

-bullying, threatening, or intimidating others

-lack of remorse and guilt

-lashing out aggressively to parents, friends, or teachers

There are many other signs that a child with conduct disorder may possess, yet these are the ones that made the most sense to me. I was so saddened to think about such young children being so destructive and causing harm to themselves and/or others. At first, I couldn’t think of ever witnessing children that portrayed anything related to conduct disorder, but as I furthered my research I was able to think of several different circumstances where I have witnessed this type of behavior. However, just because a child shows one of the signs of conduct disorder does not mean he or she has it. I will admit that I am guilty of lying (just once or twice my whole life, of course!) to avoid punishment when I was younger but I have never been thought to have conduct disorder, nor have I ever done anything such as the signs listed above.  

During a study conducted about reducing stressors relating to teacher-student relationship, Dr. Ray (2007) compared the impact of child-centered play therapy, teacher interaction only and a combination of teacher-child relationship. The results were statistically significant for each treatment group, the indication was school based play therapy intervention was more effective in facilitating a positive rapport between the teacher and child. The website: http://www.goliath.ecnext.com/coms2 provides a more in depth document about the research that was done by Dr. Ray. It was reported that school-based mental health interventions have a positive effect on academic and mental health progress for children. The interventions were more productive when received long-term and addressed multiple needs in the child’s lives.

After reviewing the study done about improving the relationship between teachers and students, I am actually more nervous about having a child with this disorder in my classroom because of how severe this disorder can be. A child that has been diagnosed with a severe conduct disorder could potentially affect the demeanor of my classroom and all of the other students. I am now wondering the specifics of what teachers can do to support these students and maintain a positive relationship with the child and the family.

Resources:

American Psychiatric Association. (2000). Diagnostic and statistical manual

of mental disorders (4^th ed. Text Revision). Washington D.C.: Author.

Ray, D. (2007). Two counseling interventions to reduce teacher-child relationship

Stress {Electronic version}. Professional School Counseling, 10(4), 428-440.

Anxiety

To review, the two emotional disorders, also known as psychiatric disorders, that I will be discussing from this point on are anxiety (also known as generalized anxiety disorder) in children and conduct disorder. I chose these because they are the most prevalent types of emotional disorders amongst elementary children. I will now answer the remaining two questions I had from my first post in relation to anxiety, starting with, What are the most common signs in children with emotional disorders? I found a video from the website, "moms homeroom" which gave me insight to how parents of young children become aware of their child's emotional issue. The video also includes idea's about how to help these children overcome, or at least deal with, the worries that cause their anxiety. The link to the video is here:
http://momshomeroom.msn.com/parenting-videos/social_issues/helping-your-child-conquer-anxiety/61?&utm_campaign=Episode%205%3A%20Big%20Day%2C%20Big%20Fears...Conquering%20Anxiety&utm_source=google&utm_medium=cpc&utm_content=Anxiety%20Symptoms&utm_term=symptoms%20of%20anxiety%20in%20children

This video includes an interview with child psychologist, Dr. Chanskey, who has been working with children that have emotional disorders for many years. According to Dr. Chanskey, some children are very verbal about their anxiety disorder and will alert their parents when they have a huge fear about doing something or if they are extremely worried about something. Other children who aren't able to express themselves verbally may cry at night and seem sad for no apparent reason, so it does help if parents are aware of anxiety signs that children often portray. Anxiety in children usually has to do with something at school because school is their life and where they spend most of their day. This was actually not what I was expecting to hear because I always thought that emotional disorders were more commonly developed after a traumatic experience outisde of the school setting such as mental or sexual abuse in the home.

According to the psychcentral website, people with anxiety will suffer from three out of the following six symptoms:

Restlessness or feeling keyed up or on edge

Being easily fatigued

Difficulty concentrating or mind going blank

Irritability

Muscle tension

Sleep disturbance (difficulty falling or staying asleep, or restless unsatisfying sleep)

This answers my question, How does emotional distress affect a child's behavior in the classroom, because if a child is not getting enough sleep and has difficulty concentrating, their preformance in school is going to suffer. Elementary children generally need at least ten hours of sleep a night, so if a child is not getting at least ten hours a sleep most nights, they will be too tired to participate and learn in the classroom. During my internship, there was a child who was extermely smart and was at the top of the class academically. However, she would constantly fall asleep and would have to be woken up during seatwork more times than not. Most of the time, my mentor would allow the child to sleep, sometimes one to two hours, while the other students were working. I'm sure that teachers and other professionals within school districts have mixed emotions about how to best handle this situation. I personally agree with my teacher allowing this child to sleep because the child would be able to actively participate for the remainder of class once she was able to sleep for an hour or so. Whenever my teacher wouldn't allow her to sleep, the child would be irritable and act out for most of the day. My teacher tried numerous times to explain to the child's parents that she needed to get more sleep at night because her preformance in class was suffering from it. The parents didn't seem concerned and the child continued to come into class exhausted. Teachers can only do so much when it comes to controlling what goes on in a students home and, in my opinion, a child's physical health is more important than academics, especially at such a young age.

As I continued my research about anxiety in children, I came across this wonderful website that includes articles and rating scales for observing/diagnosing children with an anxiety disorder. The website is: http://www.scaswebsite.com/index.php?p=1_1

I am learning so much from my research. I knew that there was a lot of information out there, but I had no idea about how effective this information will be for me when I have a classroom of my own with students suffering from emotional disorders. I will continue my blog by answering the same questions about conduct disorder for my next post :)