Treating Oppositional Defiant Disorder as a School-Based OT

by Howard Gerber on May 31, 2018

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oppositional defiant disorder occupational therapistAs a school-based occupational therapist, you may treat children with various conditions including oppositional defiant disorder. Most children occasionally test boundaries. Teens may become a little rebellious. Toddlers might frequently say no to a caregiver and do what they want. Oppositional Defiant Disorder (ODD) is different.

According to the American Academy of Child and Adolescent Psychiatry, it is estimated that one to sixteen percent of school-age children have oppositional defiant disorder. Since not all children are diagnosed, it is difficult to determine an exact percentage.

The cause of oppositional defiant disorder is not fully understood. Children with the disorder often have signs of the condition from an early age.

Signs of Oppositional Defiant Disorder

Children with oppositional defiant disorder have an ongoing pattern of hostile and uncooperative behavior towards parents, teachers and other authority figures that interferes with normal functioning. Signs of oppositional defiant disorder include:

  • A frequent irritable or angry mood
  • Refusal to listen to rules from caregivers
  • Spiteful behavior
  • Deliberate attempts to irritate other people
  • Problems with self-control
  • Inability to take responsibility for their actions

OT Interventions and Tips for Working with Students with Oppositional Defiant Disorder

Working with children with oppositional defiant disorder can present unique challenges. Having a good understanding of the condition can help you be a more effective therapist.

Occupational therapy can be beneficial for students with oppositional defiant disorder in several ways. Consider the following OT interventions when working with students with the condition:

Work on coping strategies: Kids with oppositional defiant disorder have problems controlling anger and hostility. Therapists should consider working with students on coping techniques to deal with everyday situations that can lead to stress.

Develop a routine for students to implement: Many children with oppositional defiant disorder struggle with change and transitions. Work together with teachers, students, and parents to develop a structured and predictable schedule at school and home. Although a little flexibility may be acceptable, sticking to a routine may be helpful.

Discuss lifestyle changes: Consider what lifestyle changes or modifications may help improve behavior. Improvements in sleep schedules, eating habits, and exercise may improve a child’s ability to cope better.

Work on sensory integration: Some children with oppositional defiant disorder also have sensory integration issues. Kids who are oversensitive to movement, sound, and touch may have increased problems controlling emotions and behavior. School-based occupational therapists could include interventions to address sensory problems.

Be generous with praise:  Most students like praise for a job well done. When students with oppositional defiant disorder exhibit appropriate behavior and show cooperation, positive reinforcement is helpful to motivate children.

Set clear limits: It’s common for children with oppositional defiant disorder to have problems with authority figures, such as teachers and therapists. Students may try to manipulate and push boundaries. Set clear limits right from the start.

Using some of the suggestions above may help your students meet their goals. Have you provided therapy for children with oppositional defiant disorder? What strategies worked?

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