Counseling and intervention strategies: Externalizing disorders

1. Constance J. Fournier Counseling and intervention strategies: Externalizing disorders

2. Attention Deficit Hyperactivity Disorder (ADHD) and types of ADHD Basic interventions with ADHD ADHD and the typical comorbidity Overview

3. Inattentive symptoms • Often fails to give close attention to details, or makes careless mistakes • Difficulty sustaining attention in tasks or play (rule governed behavior) • Does not seem to listen when spoken to directly ADhd

4. Inattentive symptoms continued • Does not follow through on instructions, fails to finish tasks (not due to oppositional behavior or inability to understand) • Difficulty organizing tasks or activities • Avoid, dislikes, reluctant to engage in mental effort tasks • Often loses necessary things ADHD

5. Inattention symptoms continued • Often distracted by extraneous stimuli • Often forgetful in daily activities ADHD

6. Hyperactivity symptoms • Fidgets with hands, feet, squirms in seat • Leaves seat when remaining seated is expected • Runs or climbs excessively; adolescents report restlessness • On the go, driven by a motor • Talks excessively ADHD

7. Impulsivity symptoms • Blurts out answers before the question is completed • Difficult awaiting turn • Interrupts or intrudes on others (butting into conversations or games) ADHD

8. Inattentive type • Hyperactive-Impulsive type • Combined type • Helps to put on the tri Venn diagram • Diagnosed before age 7 ADHD

9. Inattentive/impulsive Hyperactive Combined Not otherwise specified ADHD

10. Precorrections Two desks Supply paper and pencils Direct questions specifically to the child(say two questions) Allow to give hints Adhd classroom strategies

11. Developing rapport with students Announce that this is special time Only rules—do something together, no hurting self, others, or objects Let student pick activity Do a running commentary on the actions Do not correct behavior unless it is hurting self, others, or object Special time

12. Three people in a group, one is the counselor, one is the observer, and one is the child. Observer: give feedback of what the counselor did well, and what they might do better Game 1: Marcus Game 2: Courtney Connect dot game

13. Needs to be safe Needs to be predictable Helpful to most children because across the table eye to eye is very uncomfortable Sit beside or at angle, not directly across if at all possible Special time

14. pattern of negative, hostile, defiant behavior • often loses temper • argues with adults • refuses or defies adults’ requests • deliberately annoys others • blames others for own mistakes • touchy and easily annoyed by others • angry and resentful • spiteful, vindictive Oppositional Defiant disorder

15. aggression toward people and animals • bullies, threatens, intimidates • initiates fights • used a weapon that can cause serious harm • cruel to people • cruel to animals • stolen while confronting victim • forced sexual activity Conduct disorder

16. destruction of property, e.g. fire setting deceitfulness or theft, e.g., breaking into a house • serious rule violation, e.g. truancy • other considerations • Impairs social, academic, occupational functioning • not other disorders Conduct Disorder

17. Only after age 18 • Pattern of disregard for and violation of rights • failure to conform to society norms • deceitfulness • impulsivity, failure to plan ahead • irribility, aggressiveness • disregard for safety of self or others • consistent irresponsibility • lack of remorse Antisocial Personality Disorder

18. Emotional callousness is being considered for ODD and ASP • Inability to take others’ perspective • Disregard for feelings or pain caused to others • Actions for self DSM possible changes

19. Parent training (Barkeley Program for Parents) Supportive environment Structure Predictability Contracting interventions

20. Precorrections Giving choices Giving hints Using self monitoring Interventions

21. Veggie burger of feed back • 3. Top: positive • 2. Middle: feedback with “I” messages • 1. Bottom: positive

22. Case 1: Your colleague starts talking about students when you are out for coffee. You like him/her, but know this is a small world. Case 2: You are at an IEP meeting, and a teacher who needs to participate is distracting him/her self and you by constantly texting under the table. He/she is a very good teacher. cases

23. www.chadd.org • Children and adults with Attention Deficit Disorders • www.help4adhd.org • Combined resources • www.nasponline.org • National Association of School Psychologists • www.ed.gov • Department of Education resources

24. www.nichcy.org • National information center for children and youth with disabilities • www.aap.org • American Academy of Pediatrics • www.apa.org • American Psychological Association • www.aacap.org • American Academy of Child and Adolescent Psychiatry Resources