Conduct Disorder

Patrick AshtonAllison AveryKatie Messuri

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)

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)

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)

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:

o Povertyo Abuse o Neglecto ETC…

(Kauffman Chapter 13)

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)

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.

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.

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.

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.

Antisocial Behavior

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

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

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

Characteristics

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

Prevalence of Overt CD

Range from 6 to 16% of boys under the age of 18

2 to 9% of girls under 18

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.

Etiology

poverty family

disruption abuse neglect racism

poor schools lack of

employment opportunities

other social afflictions

Child Factors

Child temperament Neuropsychological deficits and

difficulties Sub-clinical levels of conduct disorder Academic and intellectual

performance

Parent and Family Factors 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

School-related Factors

Characteristics of the setting

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.

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

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

Prognosis

The prognosis for later adjustment is poor

The pattern of antisocial conduct is often transmitted over generations

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

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

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.”

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

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

Prevention Strategies

1. Provide effective consequences to deter aggression

2. Teach non-aggressive responses to problems

3. Stop aggression early before it takes root

4. Restrict access to the instrument of aggression

Prevention Strategies cont’d.

5. Restrain and reform public displays of aggression

6. Correct the conditions of everyday life that foster aggression

7. Offer more effective instruction and more attractive educational options in public schools

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

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

Social Learning Approach

Includes three primary components: Specific behavioral objectives Strategies for changing behavior by

altering the social environment Precise measurement of behavioral

change

12 Techniques 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 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

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

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

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

The Acting-OutBehavior Cycle

1. Calm2. Trigger3. Agitation4. Acceleration5. Peak6. De-escalation7. Recovery

Quiz

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

Quiz

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

Quiz

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

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?

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?

Quiz

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

Quiz

7.)(T or F) Children with conduct disorder exhibit persistent patterns of

antisocial behavior that impairs functioning.

Quiz

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

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?

Quiz

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