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Part 2 of 3: Assessing Oppositional Defiant Disorder

Part 2 of 3: Assessing Oppositional Defiant Disorder

(This three-part article is by Dr. James Sutton. It is from his newest book, “What Parents Need to Know About ODD.” This book can be downloaded in e-book format from www.docspeak.com.)

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Review of available records and reports: Unless we take a look, information valuable to treatment can remain buried. I once evaluated a fourth grade girl whose medical background indicated that she had reduced hearing in one ear and no hearing in the other. The teacher did not know this. The child was seated in the back of the room with her best ear to a wall. Behaviorally she looked indifferent, uncooperative and noncompliant. She did an abrupt turnaround with a little preferential seating.

Interviews with parents and teachers: This can be done in writing, in person, or both. I generally ask parents and teachers to write down their concerns in order of priority … on one sheet of paper (this keeps it quick, focused and concise). I ask them to also briefly list the youngster’s three best strengths or qualities. If a child has several teachers, I prefer that they all do a page on the child. It’s amazing how this little activity can quickly differentiate between problem and non-problem areas at home and school. If we don’t have to “fix” everything, the job is easier.

Perceptual-motor assessment: Some examiners would leave this one out of the assessment. I consider it to be essential with an ODD youngster because the child either doesn’t want to answer your questions initially, or they are apt to tell you what they think you want to hear (especially if they think they’re in trouble). By giving a couple of drawing tasks that require no speaking at all, I positively disrupt what the child is expecting. Also, distinct patterns of oppositional and defiant behavior can be uncovered on these instruments, often without the child even knowing it.Assessment of academic functioning: Why is this child not completing school work? Is the work too difficult (always a possibility), or is the child too difficult? This part of the assessment doesn’t have to be all that deep, but it does need to settle the issue of potential versus performance.

Assessment of intellectual functioning: IQ testing can signal areas of interest, strengths and needs, learning modalities and potential for insight, all of which are helpful in developing intervention. Extremes in intellectual functioning can present difficulty. Mentally retarded oppositional and defiant youngsters are resistant to change; they have trouble developing insight into their behavior (they have to experience consequences instead of considering “What if …” as motivation to change behavior). Of course, if a child is seriously deficient in intellectual skills, you probably already know it. Really bright youngsters, on the other hand, already know they’re smarter than the adults; they stay a jump ahead of everyone.

(to be continued)

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July 25, 2006 - Posted by | Difficult Child, Educators, Parents

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