Conduct Disorder

1. Conduct Disorder Patrick Ashton Allison Avery Katie Messuri

2. Covert Conduct Disorder • According to Kauffman Covert Conduct Disorder, also referred to as Covert Antisocial Behavior, is characterized by • Untrustworthiness • Manipulation of others • Running away • Concealment of ones acts (Kauffman Chapter 13)

3. Covert Conduct Disorder Some of the antisocial behaviors we have seen exhibited w/persons who have Covert CD are as follows: • Stealing • Lying • Fire-setting (Arson) • Vandalism • Truancy (Kauffman Chapter 13)

4. Prevalence • Prevalence statistics vary from 4 to 10% of the child population. • This estimate is for Conduct Disorder as a whole, actual Covert statistics have not been estimated precisely. • Conduct Disorders, unlike many other disorders we have learned about, are not necessarily more apparent in males or females. Kauffman tells us that the estimates for both males and females are on the rise for Conduct Disorder. • Males and Females sometimes differ in their behavior where CD is concerned. Males tend to engage in behaviors like vandalism, fighting, and stealing. Whereas females tend to engage in behaviors like lying, running away, and substance abuse. (Kauffman Chapter 13)

5. Etiology -The believed causes of Covert CD stem from poor familial connections and familial communications. Kauffman describes some of the different behaviors in the chapter and strangely enough we find that most of them deal with poor parenting skills. -In general the same causal factors that we will see for Overt CD are also applicable to Covert CD. Some of these include: • Poverty • Abuse • Neglect • ETC… (Kauffman Chapter 13)

6. Assessment/Identification • Identification of Covert Conduct Disorder is difficult because most times the behavior is not observed until long after it has begun. Hence, covert literally means, “Not openly shown, engaged in, or avowed.” (Merriam-Webster on-line). • Assessment can involve much observation and self-reports of lying, stealing, truancy, and vandalism. (Kauffman Chapter 13)

7. Intervention Tactics Examples… • Stealing • Every instance of stealing must receive consequences. • Parents must not shame or council the child at the time they discover theft. • Parents are advised to keep their eyes open for “new” property rather than searching the childs room for stolen items.

8. Tactics Cont’d • Lying • Careful monitoring • Provide reinforcement for honest behavior and punishment of lying. • Important to determine whether the student can discriminate between truth and nontruth.

9. And More… • Vandalism • Decreasing the aversiveness of the school environment by adjusting school rules, teachers’ expectations, and consequences for desirable and undesirable behavior may be more effective than increasing security and making punishment more severe.

10. Overt Conduct Disorder • Definition: A persistent pattern of antisocial behavior that significantly impairs everyday functioning at home or school or leads others to conclude that the youngster is unmanageable.

11. Antisocial Behavior • Conduct disorders encompass a broad range of antisocial behavior, such as aggressive acts, theft, vandalism, fire setting, lying, truancy, and running away.

12. Patterson Study(aggressive children) • They found that an aggressive child can be expected to be noncompliant about every 10 minutes • They are also expected to hit and to tease about every half hour

13. Patterson Study(non-aggressive children) • A non-aggressive child might be expected to be noncompliant once in every 20 minutes • to tease once in about 50 minutes • and to hit once in a couple of hours

14. Characteristics • frequent temper tantrums • often arguing with adults • refusing to obey adults • deliberately annoying other people • acting angry and resentful

15. Prevalence of Overt CD • Range from 6 to 16% of boys under the age of 18 • 2 to 9% of girls under 18

16. Boys vs. Girls • Boys with CD tend to exhibit fighting, stealing, vandalism, and other overtly aggressive, disruptive behavior. • Girls are more likely to exhibit lying, truancy, running away, substance abuse, prostitution, and other less overtly aggressive behavior.

17. poverty family disruption abuse neglect racism poor schools lack of employment opportunities other social afflictions Etiology

18. Child Factors • Child temperament • Neuropsychological deficits and difficulties • Sub-clinical levels of conduct disorder • Academic and intellectual performance

19. Prenatal complications Psychopathology and criminal behavior in the family Parent-child punishment Monitoring of the child Quality of the family relationships Marital discord Family size Siblings with antisocial behavior Socioeconomic disadvantage Parent and Family Factors

20. School-related Factors • Characteristics of the setting

21. Assessment and Identification • Self-reports or ratings of parents, teachers, or peers • While these measures are helpful, they must always be used with direct observation of the child or youth in several different settings to obtain more precise information about the problem.

22. Remember to: • Use rating scales that have multiple dimensions, because children with CD are likely to have other problems as well • Make sure you assess prosocial skills as well as CD • Compare the child to norms for others of the same age and sex • Assess the social contexts, including family, community, and school • Make provisions for periodic reassessment to measure the progress of the intervention

23. EBD Criteria • Inability to build and maintain satisfactory interpersonal relationships with peers and teachers • Inappropriate types of behaviors under normal circumstances • A general, pervasive mood of unhappiness or depression

24. Prognosis • The prognosis for later adjustment is poor • The pattern of antisocial conduct is often transmitted over generations

25. Prognosis • Children with under-socialized aggressive conduct disorder tend to exhibit a relatively stable pattern of aggressive behavior over time • Their problems tend to continue into adulthood

26. Prognosis A history of serious antisocial before age 18 increases: • Boys: the chance for externalizing psychopathology (aggression, criminal behavior, alcohol and drug abuse) in adulthood • Girls: the chance for externalizing and internalizing disorders (depression and phobias) in adulthood

27. Prognosis “Clearly, no other disorder of childhood and adolescence is so widespread and disruptive of the live of those who suffer it and the live of others.”

28. Co-morbidity • Conduct disorders are often comorbid with other disorders • ODD, ADHA, and CD are known to be closely linked • All types of CD may be comorbid with ADHD, depression, anxiety, delinquency, substance abuse, and sexual acting out

29. Prevention Strategies • Prediction of antisocial behavior is essential to prevention • Small children often exhibit the “soft” signs of antisocial behavior, and they may gradually progress to much more severe “hard” signs as they mature • It’s important to address these signs early while we still have a chance to affect them

30. Prevention Strategies • Provide effective consequences to deter aggression • Teach non-aggressive responses to problems • Stop aggression early before it takes root • Restrict access to the instrument of aggression

31. Prevention Strategies cont’d. • Restrain and reform public displays of aggression • Correct the conditions of everyday life that foster aggression • Offer more effective instruction and more attractive educational options in public schools

32. Prevention • Antisocial behavior should prompt teacher to ask what pro-social skills the student needs to learn as a replacement for aggression and to devise an explicit instructional strategy for teaching those skills

33. Intervention • Psychodynamic therapies, biological treatments, behavioral interventions • Parent management training, problem solving training, family therapy, and treatments addressing multiple social systems are more the most promising • Interventions based on social learning principles have been more successful than ones based on conceptual models

34. Social Learning Approach • Includes three primary components: • Specific behavioral objectives • Strategies for changing behavior by altering the social environment • Precise measurement of behavioral change

35. Rules: clear, explicit statements for classroom conduct Teacher Praise: positive verbal, physical, gestural indications of approval Positive Reinforcement: a presentation of a rewarding consequence that increases the future probability or strength of the behavior it follows Verbal Feedback: information about the appropriateness or inappropriateness of academic or social behavior 12 Techniques

36. 12 Techniques • Stimulus Change:is the alteration of antecedent events or conditions that set the stage for behavior • Contingency Contract:is a written performance agreement between a student and teacher • Modeling plus Reinforcing Imitation: is showing or demonstrating the desired behavior and providing positive reinforcement for matching responses • Shaping: is a process of building new responses by beginning with behavior the student already shows and reinforcing successive actions of the desired behavior

37. 12 Techniques • Systematic Social Skills Training:skills taught are those that help students • Self-monitoring and self-control training:consistent tracking and evaluating specific behaviors of ones own with the intention of changing those behaviors • Time out:the removal of a student’s opportunity to gain positive reinforcement • Response Cost:the removal of a previously earned reward or reinforcer

38. Uses and Misuses ofPunishment • Punishment: any consequence that results in a decline in the rate or strength of the punished behavior • Punishment must be used along with incentives for appropriate behavior

39. General Guidelines For EffectiveUse of Punishment • Used only by people who are warm and loving toward the student when his/her behavior is acceptable • Should be fair, consistent, and immediate • Should be of reasonable intensity • When possible, punishment should involve response cost • When possible, it should be related to the misbehavior

40. The Acting-OutBehavior Cycle • Calm • Trigger • Agitation • Acceleration • Peak • De-escalation • Recovery

41. Quiz 1.) (T or F) Covert Conduct Disorder affects Boys more than Girls:

42. Quiz 2.) Statistics suggest that Conduct Disorder affects of the child population: • 2-3% • 10-20% • 4-10% • 20-30%

43. Quiz 3.) Is Stealing considered a Covert or Overt form of Conduct Disorder?

44. Quiz 4.)One of your students, Ronnie, is constantly late to class. Ronnie also draws in his text books and sometimes he hits other students when he gets upset or angry. Does Ronnie exhibit signs of covert or overt conduct disorder?

45. Quiz 5.)What are the things you can do as a teacher to keep acting-out, aggressive behavior in your classroom to a minimum, and how are these related to cultural diversity?

46. Quiz 6.) Is Lying considered a Covert or Overt form of Conduct Disorder?

47. Quiz 7.)(T or F) Children with conduct disorder exhibit persistent patterns of antisocial behavior that impairs functioning.

48. Quiz 8.) Is Truancy considered a Covert or Overt form of Conduct Disorder?

49. Quiz 9.)One of your students, Angela, is extremely stubborn. If anyone disagrees with her, she argues with them until they admit she's right or until they walk away or the argument is broken up by you or another teacher. She is also very sassy, and brags constantly about all the things her parents buy her. Do you think Angela has overt or covert CD, and what would you do as her teacher to assuage her behavior?

50. Quiz 10.) (T or F) Comorbidity is likely to be a factor in children with CD.