CONDUCT DISODER

GROUP MEMBERS

PRESENTATION OUTLINE
Description of Conduct Disorder Causes Diagnostic criteria Treatment Intervention strategies Roles of Social Work in Conduct Disorder

DESCRIPTION
A persistent pattern of behavior in which the basic

rights of others or major age-appropriate social norms are violated. A child with a serious conduct disorder will engage in a number of unacceptable activities and seems to lack empathy and have little or no remorse, awareness, or concern that what he is doing is wrong. Conduct disordered children are usually not very articulate about their feelings and may demonstrate their pain with self destructive behaviours. Their aggression typically is expressed toward people and animals, in the destruction of property, in lying and theft, and in serious violation of society's rules

 Young people with conduct disorder may exhibit excessive levels of fighting or bullying, cruelty to other people, fire setting, stealing, repeated lying, truancy from school and running from home, unusually frequent and severe temper tantrums and defiant provocative behaviour

CAUSES
ENVIRONMENTAL
Children can learn aggressive behavior from parents who behave aggressively Children may also imitate aggressive acts elsewhere such as in television Post traumatic events such as rape, abuse (emotional, neglectance) physical poor relationship with parents

ENVIRONMENTAL CAUSES CONTINUED...

dysfunctional families, poor parenting practices, (negative reinforcement) excessive discipline) parental alcoholism, having parents with antisocial personality disorder, marital disorder, history of maltreatment or early maternal rejection

BIOLOGICAL
Neurological abnormalities/brain damage; the frontal lobe is the area in the brain that affects the ability to plan, to avoid harm and to learn from negative consequences and so if it is damaged the person can develop conduct disorder The impairment of the frontal lobe causes conduct disorder. If a person has a history of head trauma that could cause conduct disorder

GENETICAL
Genetic vulnerabilitys familiar transmission is suggested by data that show a high prevalence of antisocial personality disorder in both mothers and fathers of children with conduct disorder. adoptive parents of conduct disordered children have not been proud to have antisocial problems/alcoholism the connection between the parents and the childs conduct problems may be at least partly genetic Twin studies show consistently higher concordance rates for antisocial behaviors in identical pairs then in fraternal pairs. If one twin has Conduct disorder, the other twin has a 70% chance of also having the disorder sometimes in life.

DIAGONSTIC CRITERIA
have to be under the age of 18. have a repetitive and persistent pattern of behavior that violates the basic rights of others or age-appropriate societal norms or rules The actions of the child must cause clear negative consequences in the childs social, familial or educational functioning. To be more specific you have to meet three or more of the following criteria in the past 12 months, with at least one criterion present in the past 6 months:

Aggression to people and animals

often bullies, threatens, or intimidates others often initiates physical fights has used a weapon that can cause serious physical harm to others (e.g., a bat, brick, broken bottle, knife, gun) has been physically cruel to people has been physically cruel to animals has stolen while confronting a victim (e.g., mugging, purse snatching, extortion, armed robbery) has forced someone into sexual activity (is a rapist)

CONTINUED... Destruction of property

8, has deliberately engaged in fire setting with the intention of causing serious damage 9, has deliberately destroyed others' property (other than by fire setting)

CONTINUED... Deceitfulness or theft

10, has broken into someone elses house, building, or car 11, often lies to obtain goods or favors or to avoid obligations (i.e., cons others) 12, has stolen items of nontrivial value without confronting a victim (e.g., shoplifting, but without breaking and entering; forgery)

CONTINUED... Serious violations of rules

often stays out at night despite parental prohibitions, beginning before age 13 years has run away from home overnight at least twice while living in parental or parental surrogate home (or once without returning for a lengthy period) is often truant from school, beginning before age 13 years

TREATMENT
Promote social and scholastic learning
Treatment involves more than the reduction of antisocial behaviour stopping tantrums and aggressive outbursts, while helpful, will not lead to good functioning if the child lacks the skills to make friends or to negotiate positive behaviours need to be taught too Specific intellectual disabilities such as reading retardation, which is particularly common in these children, need to be addressed, as do more general difficulties such as planning homework.

Parent management training

Treatment can be delivered in individual parentchild sessions or in a parenting group. Individual approaches offer the advantages of live observation of the parentchild play and therapist coaching and feedback regarding progress

 MEDICATION
Medications are rarely used in the treatment of conduct disorders since these disorders are behavioral in nature. Medication is often used in the treatment of psychological and psychiatric disorders which may occur simultaneously (e.g. depression, anxiety).

TREATMENT CONTINUED...
Child therapies
The most common targets of cognitivebehavioural and social skills therapies for children are aggressive behaviour, social interactions, self-evaluation and emotional dysregulation In practice most programmes cover all four areas to a greater or lesser extent

INTERVENTION STRATEGIES TO ADDRESS THE ILLNESS

Parent management training
Programmes have been designed to improve parents behaviour management skills and the quality of the parentchild relationship. Interventions may also address distal factors likely to inhibit change, for example parental drug or alcohol misuse, maternal depression and violence between parents

INTERVENTION STRATEGIES CONTINUED

Interventions in school Interventions to promote positive behaviour
Typically, teachers are taught techniques for use with all children in their class, not just those exhibiting the most antisocial behaviour. Successful approaches use proactive strategies and focus on positive behaviour and group interventions, combining instructional strategies with behavioural management

INTERVENTION STRATEGIES CONTINUED

A productive intervention for parents is learning good communication skills. Parents should be able to communicate clear, direct and specific rules, request or expectations.

Parents should expect the child to react in a concise manner. There should be respect from each party and rules need to be enforceable. Parents of children with conduct disorder rely on inconsistent coercion which increases the negative climate of the home

INTERVENTION STRATEGIES CONTINUED

INTERPERSONAL AND SKILLS TRAINING
Provides children with individual experience and social skills that may be lacking which lead to conflict. Trains children how to initiate conversations, respond to others, refuse requests, and make requests of others.

PEER INTERVENTION
To replace deviant group peer with social appropriate group Promote pro social interaction with peers at school

ROLES PLAYED BY THE SOCIAL WORKER

Enabler: In the enabler role, a social worker helps a client become capable of coping with situations or transitional stress. Mediator: The mediator role involves resolving arguments or conflicts in the involved parties Integrator/Coordinator: Integration is the process of bringing together various parts to form a unified whole. E.g the family of the person with conduct disorder. Educator: The educator role involves giving information and teaching skills to clients and other systems.

CONCLUSION
Children misbehave for a variety of different reasons but that does not imply that they have conduct disorder. As a child matures there is an expectation that he will increasingly able to resolve much of his distress on his own and will express his feelings through words rather than outwardly directed misbehaviour. In the case of conduct disordered children they will continue misbehaving and not know that what they are doing is wrong. The behaviour becomes extreme and children will not know how to resolve it.

REFERENCES
Dishion, T. J., McCord, J. & Poulin, F. (1999) When interventions harm. Peer groups and problem behavior. American Psychologist, 54, 755764. Levendoski, L. S. & Cartledge, G. (2000) Selfmonitoring for elemen tary school children with serious emotional disturbances. Classroom applications for increased academic responding. Behavioral Disorders, 25, 211224. Nelson, J. R., Smith, D. J., Young, R. K., et al (1991) A review of self-management outcome research conducted with students who exhibit behavioral disorders. Behavioral Disorders, 16, 168179

THANK YOU!!!!!

ROLE PLAY GROUP 5

At the Mudongo Household

ON THE WAY TO SCHOOL

AT SCHOOL

AT HOME WITH THE MOTHER

AT SCHOOL AND INTERVENTION BY SOCIAL WORKER

END OF ROLE PLAY