Oppositional Defiant Disorder (ODD)--

All children are oppositional from time to time, particularly when tired,
hungry, stressed or upset. They may argue, talk back, disobey, and defy
parents, teachers, and other adults.   Oppositional behavior is often a
normal part of development for two to three year olds and early
adolescents.  However, openly uncooperative and hostile behavior
becomes a serious concern when it is so frequent and consistent that it
stands out when compared with other children of the same age and
developmental level and when it affects the child's social, family, and
academic life.

In children with
Oppositional Defiant Disorder (ODD), there is an
ongoing pattern of uncooperative, defiant, and hostile behavior toward
authority figures that seriously interferes with the youngster's day to
day functioning.

Symptoms of
ODD may include:

  • frequent temper tantrums
  • excessive arguing with adults
  • active defiance and refusal to comply with adult
    requests and rules
  • deliberate attempts to annoy or upset people
  • blaming others for his or her mistakes or misbehavior
  • often being touchy or easily annoyed by others
  • frequent anger and resentment
  • mean and hateful talking when upset
  • seeking revenge

The symptoms are usually seen in multiple settings, but may be more
noticeable at home or at school.  Five to fifteen percent of all schoolage
children have ODD.  The causes of ODD are unknown, but many parents
report that their child with ODD was more rigid and demanding than the
child's siblings from an early age.  Biological and environmental factors
may have a role.

A child presenting with ODD symptoms should have a comprehensive
evaluation.  It is important to look for other disorders which may be
present; such as, attention deficit hyperactive disorder (ADHD),
learning disabilities, mood disorders (depression, bipolar disorder) and
anxiety disorders. It may be difficult to improve the symptoms of ODD
without treating the coexisting disorder. Some children with ODD may
go on to develop conduct disorder.

Treatment of ODD may include:

  • Parent Training Programs to help manage the child's
    behavior
  • Individual Psychotherapy to develop more effective
    anger management
  • Family Psychotherapy to improve communication
  • Cognitive Behavioral Therapy to assist problem solving
    and decrease negativity
  • Social Skills Training to increase flexibility and
    improve frustration tolerance with peers

A child with ODD can be very difficult for parents. These parents need
support and understanding.  Parents can help their child with ODD in
the following ways:

  • Always build on the positives, give the child praise and
    positive reinforcement when he shows flexibility or
    cooperation.

  • Take a time-out or break if you are about to make the
    conflict with your child worse, not better.  This is good
    modeling for your child.  Support your child if he
    decides to take a time-out to prevent overreacting.

  • Pick your battles.  Since the child with ODD has trouble
    avoiding power struggles, prioritize the things you
    want your child to do.  If you give your child a time-
    out in his room for misbehavior, don't add time for
    arguing. Say "your time will start when you go to your
    room."

  • Set up reasonable, age appropriate limits with
    consequences that can be enforced consistently.

  • Maintain interests other than your child with ODD, so
    that managing your child doesn't take all your time
    and energy.  Try to work with and obtain support from
    the other adults (teachers, coaches, and spouse)
    dealing with your child.  

  • Manage your own stress with exercise and relaxation.
    Use respite care as needed.

  • Many children with ODD will respond to the positive
    parenting techniques.  Parents may ask their
    pediatrician or family physician to refer them to a
    child and adolescent psychiatrist, who can diagnose
    and treat ODD and any coexisting psychiatric condition.
On their own, children cannot overcome
Oppositional Defiant Disorder (ODD). Their
“bad behavior/attitude” cannot be “solved”
with medication, herbal supplements, vitamins
or a special diet. Successful treatment of
ODD requires Parent Education Training
(PET) that involves:

(a) promoting the development of self-reliance
in children,

(b) providing positive attention to children when they
behave according to parental expectations, and

(c) issuing an appropriate consequence when children do
not meet parental expectations.

Additional examples of effective parenting methods in raising ODD
children include:

·   Allowing children to make wrong choices, thus giving
them wisdom; experience is a great teacher

·   Attending to children by using active listening, empathy,
paraphrasing, validation, and hugs rather than giving them
unearned privileges, food, gifts, fun activities, etc.

·   Avoiding over-indulgent parenting

·   Avoiding power struggles

·   Avoiding slipping into parental-rages

·   Avoiding trying to save children from negative
consequences and painful emotions associated with their
poor choices

·   Developing a consistent daily schedule for children

·   Differentiating between children’s wants and needs

·   Expecting children to resist assertive parenting strategies

·   Expecting set backs and relapses, and preparing with a
plan to manage those times

·   Following through with consequences rather than
“nagging”

·   Forgiving and letting go of things that children did in the
past

·   Giving children a certain amount of control

·   Giving children a chore to do each day  

·   Giving effective time-outs

·   Giving equal love to all children, but parenting them
differently

·   Giving only one warning before following through with
consequences

·   Issuing a consequence without retracting it

·   Learning to say “no”

·   Modeling the behaviors that parents want children to copy

·   Monitoring television and computer use

·   Offering acceptable choices to children

·   Only giving children gifts on very special occasions (e.g.,
birthdays, Christmas, graduation)

·   Parents taking time for themselves

·   Picking battles carefully

·   Recognizing and praising children’s good behaviors and
positive characteristics

·   Remaining calm and unemotional in the face of opposition

·   Setting limits on undesirable behavior

·   Starting each day with a fresh outlook and a clean slate

·   Taking away privileges for a short period of time (usually
1-7 days)

·   Working with spouses or others to assure consistent and
appropriate discipline procedures

Learning these skills may require counseling, parenting classes or other
forms of education, and consistent practice and patience.

Counseling can provide an outlet for mental health concerns that could
interfere with the successful parenting of children's symptoms. A
depressed or anxious parent may disengage from his or her child, and
that can trigger or worsen oppositional behaviors.
Oppositional Defiant Disorder