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christian counseling today
Vol. 20 no. 2
Disruptive disorders tend to be clustered in
three specific conditions: ADHD, Oppositional
Defiant Disorder (ODD), and Conduct Disorder
(CD). Although there is considerable overlap
with indications of comorbidity, these are seen as
distinctly diagnosed disorders. A thorough assess-
ment is critical in order to begin seeing results
with empirically supported treatments.
Assessment
An accurate evaluation and diagnosis of the
defiant disorders grouping and other comorbid
conditions include the following assessment tools:
n
Structured Interview:
Diagnostic Interview
Schedule for Children & Adolescents –
Revised (August, Raswell & Thomas, 1998)
and Diagnostic Interview Schedule for
Children, Version IV (Jensen et al., 1996)
n
Behavioral Rating Scales:
Behavioral
Assessment System for Children – 2 (R.W.
Reynolds & Kamphaus 2008), Child
Behavioral Checklist, Impairment Rating
Score (Achenbauch & McConaughy, 1996)
One complicating factor involved in defiant
disorders is the comorbidity of mood disorders.
Depression, learning disabilities, and substance
use disorders are some of the more common
co-occurring disorders. ADHD also tends to be
prevalent within ODD and CD, so it is essential
to know and treat ADHD, as well as the other
disorders.
Attention Deficit Hyperactivity
Disorder
“I can’t seem to get through to Derek at school. He
can’t seem to focus on the task and tends to wander
off during group time. He is in real danger of
failing.”
ADHD is the most common of the neurobe-
havioral disorders in childhood. According to the
recently published 5th edition of the
Diagnostic
and Statistical Manual of Mental Disorders
(American Psychiatric Association, 2013), it is a
persistent pattern of inattention and/or hyper-
activity that is more frequent and severe with
children at that stage of development. Prevalence
among school-aged children is estimated at
about 3–7%. The core characteristics of ADHD
include:
n
Inattention
n
Hyperactivity
n
Impulsivity
