risk and resilience emotional/behavioural disorders conduct disorder oppositional defiant disorder...

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Risk and resilience Emotional/Behavioural Disorders Conduct disorder Oppositional defiant disorder Anxiety disorders

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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

Exercise

Brainstorm how you could introduce some of these protective factors into the school.

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

Reflection

In one short paragraph outline: The concepts from the readings/course

notes that you were hoping to apply Your contribution How your contribution successfully

applied those concepts