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  1. Oppositional and Defiant Behavior By Mary Ann Grochowski

    Mary Ann Grochowski

    Mary Ann Grochowski

    Definition of Oppositional Defiant Disorder as outlined in DSM IV: A recurrent pattern of negativistic, disobedient, and hostile behavior towards authority figures that persists for at least six months and is characterized by the frequent occurrence of at least four of the following behaviors:
    • losing temper
    • arguing with adults
    • actively defying or refusing to comply with the requests or rules of adults
    • deliberately doing things that will annoy other people
    • blaming others for his or her own behavior or mistakes
    • being touchy or easily annoyed by others
    • being angry or resentful
    • being spiteful or vindictive.
    The behavior must occur more frequently than is typically occurring in children of comparable age and developmental level and must lead to significant impairment in social, academic, or occupational functioning. Most typically the negativistic and defiant behavior is present in the child’s home but is not always present in school or with other social settings. There is often a vicious cycle in which the parent and child persistently provoke each other. It is more common in families in which there has been inconsistent childcare or harsh or neglectful child rearing practices. Normal Developmental Behaviors Periods of oppositional, defiant behavior are very common around ages 2-5 and again in early adolescence. Boys typically show more behavior problems before puberty. But after puberty, the ratio of boys to girls with oppositional behavior appears about equal. Many children who are oppositional, hostile or defiant may be suffering from a temporary adverse situation in their environment, low self-esteem, depression, anxiety, or some other difficulty such as Attention Deficit Hyperactivity Disorder (ADHD). Referral to a therapist familiar with childhood disorders is advisable if:
    1. The oppositional behavior has begun to affect the child’s school performance.
    2. The child’s behavior seriously disrupts the family milieu to the point siblings are also impacted or parental schedules are routinely ineffective.
    3. The child’s behavior changes from oppositional to aggressive.
    4. The child becomes isolated from family and friends.
    5. Parents are feeling overwhelmed, vulnerable or fearful of their own interaction with the child.
    Ways to Help Your Child Improve
    1. Try to understand the feeling behind the behavior.
    2. Pay attention to your child’s interests and play.
    3. Use praise and positive attention to promote compliance.
    4. Offer rewards for good behavior.
    5. Use discipline that is a direct consequence of the misbehavior.
    6. Use time outs to promote emotional control.
    7. Plan ahead for public activities and events your child may find uncomfortable.
    8. Work with your child’s school to encourage understanding.
    9. Get support for yourself. Parents need to work together. If you are a single parent, find a friend or other relative to give you outlets.
    10. Take time to set your own priorities and goals.
    Always try to use positive statements when relating to your child rather than negative. Use Power Talk to communicate using ”I” statements rather than blaming “You statements.” Power Talk Formula: I feel: When you:_______________________________ Because:_____________________________________ Please:______________________________________ If you must approach your child with a negative criticism, try the “Sandwich” approach by first making a positive statement about your child; then state the negative, and follow with another positive statement. Example: “John, that was very generous of you to share your computer time with your brother. I’ve noticed that your homework has not gotten much attention lately, though. I am sure that from now on you are going to be more conscientious of making your homework a priority.” Remember, flexibility within a structure is also important There are no universal tried and true parenting rules other than love and understanding. Being a good parent is hard work so praise yourself for trying and acknowledge your successes. Learn to laugh at your imperfections and get lots of hugs! For additional information or to make an appointment with Mary Ann contact: Mary Ann Grochowski American Behavioral Clinics 7330 West Layton Avenue Milwaukee, Wisconsin 53220 Phone: (414) 281-1677   References Gordon, Thomas PET Parent Effectiveness Training NY Plume/Penguin 1975 Faber, Adele and Mazlish, Elaine Siblings Without Rivalry NY Avon Books, 1998 Greene, Ross The Explosive Child NY Harper Collins 1998 Barkley, Russell Your Defiant Child NY Guilford 1998
  2. Saving Our Daughters By Dr. Stacey Nye, PhD, FAED

    I am often asked how to prevent eating disorders in our children, for it is quite common that weight and body image issues plague our kids, especially girls, at a younger and younger age. The ever-growing exposure to media images of thin, beautiful, perfect-looking women set a standard that most women cannot achieve, and all our girls should not strive for. Below you will find a list of suggestions of how you can help prevent these issues from hurting a girl that you love.
    1. Be aware of your own weight issues. Kids learn by modeling, and if they see a parent dieting, whether or not they are told directly, they will get the message that one needs to lose weight to be beautiful or accepted. Stop weighing yourself and get rid of the scale if you have one.
    2. Help your daughter develop criteria for self esteem that go beyond appearance, such as relationships, academic successes, or hobbies. If she has a solid sense of self (identity) and a stable self-esteem, research shows she will be more resilient to society’s destructive influences to conform.
    3. Reduce exposure to negative media images. Research shows that looking at pictures of emaciated fashion models results in lowered self esteem among girls and women. Look for magazines or television shows with more realistic images. When this is not possible, help your daughter to discern the difference between fantasy (few people look like Jennifer Aniston; most magazine photos are airbrushed or digitally perfected) and reality (the average women is 5’4″ and weighs 145lbs).
    4. Teach your daughter how to exercise for strength, fitness and health, not just weight control.  Help her to find team sports, yoga classes or self-defense training as a way to have fun, feel good and take care of herself.
    5. Help your daughter to expand her definition of beauty and accept differences amongst people in general. Being unique is special and diversity is necessary for survival.
    6. If there are weight issues, review the family tree. Weight is 3/4 genetics, and it would be unrealistic to expect a child to be significantly thinner than most of her family. Otherwise, try to evaluate if your child is eating for more reasons than just hunger. While it is common to occasionally overeat at holidays or special occasions, normal eaters tend to eat when they’re hungry and stop when they’re full. If she is not doing this, she may have a problem with emotional eating.
    7. Familiarize yourself with the risk factors and warning signs of negative body image and eating disorders. Perfectionistic, people-pleasing girls are at risk for demanding perfection in their appearance and swallowing their negative feelings, resulting in obsessing about food and weight as a way to feel in control.  Watch for preoccupation with food and/or weight, avoidance of eating, binge eating, disappearing after meals, or extreme weight loss as potential indicators of an eating disorder.
    8. Finally, if your daughter shows signs of depression, emotional eating or extreme dieting or weight loss, seek professional help.  Eating disorders and body image issues are easier to treat in the early stages, before they develop into long-standing, fixed patterns of coping that are resistant to intervention.
    American Behavioral Clinics
    (262) 241-3231
    Recommended reading: Reviving Ophelia. Saving The Selves of Adolescent Girls. Mary Pipher, Ballantine Books, 1994. The Body Project. An Intimate History of American Girls. Joan Jacobs Brumberg, Random House, 1997. Am I Fat?  Helping Young Children Accept Differences in Body Size. Joanne Ikeda & Priscilla Naworski, ETR Associates, 199 “Treatment will make you “weller than well”.  It will not cure all of life’s ills.  Instead, it helps one deal with issues so adaptively and constructively that the improved functioning is even better than what is considered normal” – Karl Menninger

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