Scenario
Ryan is a 12 year old diagnosed with Oppositional Defiant Disorder (ODD). As a small child, Ryan was first diagnosed with Attention Deficit, Hyperactivity Disorder. He had just started preschool and was unable to remain in one place for more than a minute or two. His parents had already had a very difficult time in disciplining him, because he would become very upset and throw temper tantrums when he could not do as he wished. He just seemed to be an unhappy, irritable child. This behavior continued in school. As time progressed, Ryan was diagnosed with Oppositional Defiant Disorder, because he continued to refuse to listen to adults and comply with the rules.
By the age of 12, he has begun to bully and annoy others. His parents have decided that the approaches they have used in the past are not working, and they are more afraid his behavior will only get worse.
Initial Post
Provide explanations for these questions and statements:
- Describe the behaviors apparent for each disorder in this scenario (Attention Deficit Hyperactivity Disorder and Oppositional Defiant Disorder).
- If this behavior becomes worse and Ryan starts to violate the rights of others, what medical diagnosis will be given and why?
- Discuss at least two types of medication appropriate to treat Ryan and support your choices with rationale and credible resources
- Describe why therapy for the parent is important in this scenario including at least two supporting rationales.
After your initial post
- Review the posts of two classmates.
- In each post identify new knowledge gained.
- Describe how this new knowledge will impact your nursing practice including specific examples and credible resources
Please make your initial post by midweek, and respond to at least two other student’s post
Student #1
For Attention Deficit Hyperactivity Disorder, the apparent behaviors comprise inattentiveness, and hyperactivity, and impulsiveness. Signs of inattentiveness include having difficulties in organizing tasks, appearing forgetful, being easily distracted and having a short attention span, inability to stick to tasks that either time consuming or tedious, making careless mistakes, constantly changing tasks or activities, and being unable to listen to or carry out instructions. On the other hand, signs of hyperactivity and impulsiveness include the inability of sitting still, more so in a quiet or calm environment, incapability of concentrating on tasks, frequently fidgeting, too many physical movements, excessive talking, being unable to wait their turn, and acting without thinking, interrupting conversations, and having little or no sense of danger. These behaviors can result in considerable problems in a child’s life, including school underachievement, poor social interaction with other children, and problems with discipline (Muratori et al., 2020)
For Oppositional Defiant Disorder, the apparent behaviors include angry and irritable mood, argumentative and defiant behavior, and vindictiveness. In an angry and irritable mood, the child often and easily losses temper, regularly gets angry and resentful and quickly gets annoyed by others. In argumentative and defiant behavior, the child frequently argues with an adult or people in authority, actively refuses to comply with an adult’s request or rules, deliberately upsets people, and often blames others for their mistakes. In vindictiveness, the child often shows s spitefulness or vindictive behavior (Muratori et al., 2020).
If this behavior becomes worse and Ryan starts to violate the rights of others, Ryan will be diagnosed with conduct disorder. This is because he exhibits aggressive behaviors such as threatens or causes physical harm hence violating their rights. It may also comprise destructive behaviors which involve the destruction of properties and vandalism. Moreover, he will be diagnosed with conduct disorder since he violates the established social rules and engages in behaviors that are not applicable for his age (Muratori et al., 2020).
One of the medications appropriate to Ryan is the use of stimulants. The rationale is that stimulants help reduce vandalism, stealing, verbal and physical aggression, and negative peer interactions. Though stimulant medication will not teach Ryan new skills, such as helping him identify and react appropriately to other’s social signals, it may reduce the violence that comes in creating relationships with others. Another medication appropriate to Ryan is explicit behavioral techniques implemented at home and school. Typically, these approaches entail training the child to become more aware of his anger and understand diverse coping strategies. The rationale is that the parent can learn how to manage the behavior through negotiation, problem-solving, and avoid possible explosive situations (Waldman et al., 2021).
In this scenario, parental therapy is critical since it equips the parents with skills to help them manage the child’s behavior. During this training, the parents will work with a behavioral therapist to understand strategies of creating structure, give consistent discipline, reinforce good behavior and strengthen the connection with their child through positive communication (Waldman et al., 2021).
References:
Muratori, P., Conversano, C., Levantini, V., Masi, G., Milone, A., Villani, S., … & Gemignani, A. (2020). Exploring the Efficacy of a Mindfulness Program for Boys With Attention-Deficit Hyperactivity Disorder and Oppositional Defiant Disorder. Journal of attention disorders, 1087054720915256Waldman, I. D., Rhee, S. H., Levy, F., & Hay, D. A. (2021). Causes of the overlap among symptoms of attention deficithyperactivity disorder, oppositional defiant disorder, and conduct disorder. In Attention, genes, and ADHD (pp. 115-138). Psychology Pr
Student #2
Like in the scenario, ADHD begins in childhood. According to Mayo Clinic this may contribute to low self esteem, troubled relationships, and difficultly at school or work. Oppositional Defiant Disorder, is marked in a child and exhibits disobedient behavior to authority figures. The cause of this is unknown but likely involves a combination of genetic and environmental factors. Symptoms usually begin before 8 years of age.
If this behavior continues he could be diagnosed as bipolar or antisocial disorder, which is a disregard for other people according to Mayo Clinic.
Ryan may be given a stimulant, which increase neurotransmitter levels, heart rate , and blood pressure, and may balance mood. Cognitive enhancing medication, improves mental function, lowers blood pressure, and may balance mood. Antihypertensive drug lower blood pressure.
Therapy is important for the parent. According to CDC parents have the greatest influence on their young child behavior. Rationale would be, Only therapy that focuses on training parents is recommended for young children are not mature enough to change their own behavior without the help of their parents. Another rationale is parents learn skills and strategies to help their child with ADHD succeed at school, at home, and in relationships. (CDC, 2021).
Reference
CDC. (Last updated Sept. 23, 2021). Parent Training In Their Behavior Management for ADHD. Attention -Deficit/Hyperactivity Disorder. https://cdc.gov/ncbddd/adhd/behavior-therapy.html
Mayo foundation for education and research. (1998-2022). Attention- Deficit hyperactivity disorder(ADHD) in children. Mayo Clinic. https://Mayoclinic.org/diseases-conditions/adhd/symptoms-causes/syc-20350889
