Download Document

Constance J. Fournier
COUNSELING AND INTERVENTION STRATEGIES:
EXTERNALIZING DISORDERS
OVERVIEW
Attention Deficit Hyperactivity Disorder (ADHD)
and types of ADHD
 Basic interventions with ADHD
 ADHD and the typical comorbidity

ADHD
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

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

Inattention symptoms continued
 Often
distracted by extraneous stimuli
 Often forgetful in daily activities
ADHD

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

Impulsivity symptoms
 Blurts
out answers before the question is
completed
 Difficult awaiting turn
 Interrupts or intrudes on others (butting into
conversations or games)
ADHD
Inattentive type
 Hyperactive-Impulsive type
 Combined type

 Helps

to put on the tri Venn diagram
Diagnosed before age 7
ADHD
Inattentive/impulsive
 Hyperactive
 Combined
 Not otherwise specified

ADHD CLASSROOM STRATEGIES
Precorrections
 Two desks
 Supply paper and pencils
 Direct questions specifically to the child(say
two questions)
 Allow to give hints

SPECIAL TIME
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

CONNECT DOT GAME
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

SPECIAL TIME
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

OPPOSITIONAL DEFIANT DISORDER
 pattern
 often
of negative, hostile, defiant behavior
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
CONDUCT DISORDER

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
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
ANTISOCIAL PERSONALITY DISORDER
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

DSM POSSI BLE CHANGES

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
INTERVENTIONS
Parent training (Barkeley Program for Parents)
 Supportive environment
 Structure
 Predictability
 Contracting

INTERVENTIONS
Precorrections
 Giving choices
 Giving hints
 Using self monitoring

VEGGIE BURGER OF FEED BACK

3. Top: positive

2. Middle: feedback with
“I” messages

1. Bottom: positive
CASES

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.
RESOURCES

www.chadd.org


www.help4adhd.org


Combined resources
www.nasponline.org


Children and adults with Attention Deficit Disorders
National Association of School Psychologists
www.ed.gov

Department of Education
RESOURCES

www.nichcy.org


www.aap.org


American Academy of Pediatrics
www.apa.org


National information center for children and youth with
disabilities
American Psychological Association
www.aacap.org

American Academy of Child and Adolescent Psychiatry