Prompt

Station A is history and formulation with a parent of a 7-year-old with multi-setting defiance. Station B is shared planning: parent training, school liaison, ADHD screen and safety-netting without inappropriate medication.

Station objectives

Take a multi-informant-ready history of defiance with settings, duration and impairment. [4]
Explain the coercive cycle without blaming the parent as “the problem.” [9]
Counsel parent training as first-line with concrete next steps. [5] [11]
Plan school consistency and ADHD screening. [18]
Refuse inappropriate first-line antipsychotic for mild defiance and safety-net. [6]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References6Show ledger

[4]Steiner H Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry, 2007.PMID 17195736
[5]Scott S Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ, 2001.PMID 11473908
[6]Gorman DA Canadian guidelines on pharmacotherapy for disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, or conduct disorder. Can J Psychiatry, 2015.PMID 25886657
[9]Dishion T The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change. Behav Ther, 2016.PMID 27993335
[11]Kaminski JW A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol, 2008.PMID 18205039
[18]Wolraich ML Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 2019.PMID 31570648

Station objectives

Take a multi-informant-ready history of defiance with settings, duration and impairment. [4]

Explain the coercive cycle without blaming the parent as “the problem.” [9]

Counsel parent training as first-line with concrete next steps. [5] [11]

Plan school consistency and ADHD screening. [18]

Refuse inappropriate first-line antipsychotic for mild defiance and safety-net. [6]

Paediatrics Fellowship Pro

You have read the opening of this case. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References6Show ledger

[4]Steiner H Practice parameter for the assessment and treatment of children and adolescents with oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry, 2007.PMID 17195736
[5]Scott S Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ, 2001.PMID 11473908
[6]Gorman DA Canadian guidelines on pharmacotherapy for disruptive and aggressive behaviour in children and adolescents with attention-deficit hyperactivity disorder, oppositional defiant disorder, or conduct disorder. Can J Psychiatry, 2015.PMID 25886657
[9]Dishion T The Oregon Model of Behavior Family Therapy: From Intervention Design to Promoting Large-Scale System Change. Behav Ther, 2016.PMID 27993335
[11]Kaminski JW A meta-analytic review of components associated with parent training program effectiveness. J Abnorm Child Psychol, 2008.PMID 18205039
[18]Wolraich ML Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics, 2019.PMID 31570648

Defiance management OSCE — parent counselling and behaviour plan

Station objectives

Defiance management OSCE — parent counselling and behaviour plan

Station objectives