Oppositional Defiant Disorder

Bridgette Mack

Single Case Design Proposal

Pine Forest Middle School (PFMS), home of the Raiders, is an institute that provides opportunities for each student to grow and work to their high potential, by educating their students.  In order to ensure the student succeeds academically and socially in a safe and healthy school environment, Cumberland County Schools employ Social Workers to address the needs of at risk and specials need students.  In the Student Services department, the social worker and/or guidance counselors operates under the Social Work Program (SWP) designed to strengthen and facilitate the educational process by identifying, modifying, and removing barriers to learning while promoting wellness and student/faculty successes.  In some instances the children could be troubled and suffering from emotional and/or behavioral disorders and this program can provides treatment by utilizing modifications of the therapeutic approaches.

Client Problem

Kaplan is an 11-year-old male, in the sixth grade suffering from Oppositional deviant disorder (ODD).  He resides with his mother.  His father is absence from his life.  He is the only child.  From the beginning of the school year up to six months after, he has been presenting disrupting behavior.  He refused to comply with the rules and requests of his teacher by ripping up handouts passed out by his teachers or classmates.  He would often yell and curse at them.  He often slammed his fists on his desk and throws his book on the floor.  One day while in math class he got up, threaten, and kicked another child’s desk for getting the question right he had gotten wrong.  The school administration referred him to the school’s social worker because they felt his behaviors and outbursts were interfering with his ability and others to learn while in school.  

Literature Review

        Oppositional defiant disorder (ODD) is one of the most common disorders among children in clinical populations, with one study finding a lifetime prevalence estimate of 10.2% in the United Sates (Nock, M., & Kurtz, S. M. S., 2008, p. 361).  Oppositional defiant disorder (ODD) is defined by ongoing patterns of negative, disobedient, or rebellious behavior indicated towards authority figures also known as disruptive behavior disorder (DBD).  The child with ODD tends to constantly disrupt those around them. The symptoms are usually seen in multiple settings, but may be noticeable at home and school.  Research has shown that one to sixteen percent of all school-age children and adolescents have ODD and most common in boys. The causes of ODD are unknown but the biological, psychological and social factors may have a role (American Academy of Child and Adolescent Psychiatry, 2013, p. 127).

Single case designs are believed to be a direct result of the study of B.F. Skinner who related the methods of operant conditioning to subjects and measured the results at numerous points in time. Because of this, single case designs are often considered the design of choice when measuring behavioral change or when performing behavioral modification. This design relies on the evaluation of treatment effects on a single individual (Smith, Handler, & Nash, 2010, p. 595).  An important aspect of this type of study is the gathering of pretest information, often called a baseline measure. It is important to measure the dependent variable or behavior prior to administering any treatment. Without this information, it would be challenging, and likely unreasonable to conclude if any change has occurred. Also often associated with this design are periods of measurement to determine not only a change but also the degree of change through the process of behavioral modification (Nock, M., & Kurtz, S. M. S., 2008, p. 361).  In this case, the most successful treatment models for Kaplan would include interventions such as Individual (anger management) and Family (parent management training) Therapy with the help of the school social work program.  The program most effective using the interventions is the Incredible Years Program that coincides with all three interventions.  Dr. Carolyn Webster Stratton created the program and it has been commonly used as an intervention approach that focuses on individual and parent therapy and has had quantitative success.  The quantitative success has shown that it can successfully measure the changes and frequency of symptoms for children after treatment in the program.