Oppositional Defiant Disorder / ODD
Even the best-behaved children can be difficult and challenging at times. But if your child or teen has a persistent pattern of tantrums, arguing, and angry or disruptive behavior toward you and other authority figures, he or she may have oppositional defiant disorder (ODD).
Contributing causes may be a combination of inherited and environmental factors, including:
- A child's natural disposition
- Limitations or developmental delays in a child's ability to process thoughts and feelings
- Lack of supervision
- Inconsistent or harsh discipline
- Abuse or neglect
- An imbalance of certain brain chemicals, such as serotonin
It may be difficult at times to recognize the difference between a strong-willed or emotional child and one with oppositional defiant disorder. It's normal to exhibit oppositional behavior at certain stages of a child's development. But there is a range between the usual independence-seeking behavior of children and that of oppositional defiant disorder.
Signs of ODD generally begin before a child is 8 years old.
The following are behaviors associated with ODD:
- Hostility directed toward authority figures
These behaviors might cause your child to regularly and consistently:
- Have temper tantrums
- Be argumentative with adults
- Refuse to comply with adult requests or rules
- Annoy other people deliberately
- Blames others for mistakes or misbehavior
- Acts touchy and is easily annoyed
- Feel anger and resentment
- Be spiteful or vindictive
- Act aggressively toward peers
- Have difficulty maintaining friendships
- Have academic problems
- Feel a lack of self-esteem
Many children with oppositional defiant disorder have other treatable conditions, such as:
- Attention-deficit/hyperactivity disorder (ADHD)
- Learning and communication disorders
If these conditions are left untreated, managing ODD can be very difficult for the parents, and frustrating for the affected child. Children with oppositional defiant disorder may have trouble in school with teachers and other authority figures and may struggle to make and keep friends.
Treating oppositional defiant disorder generally involves several types of psychotherapy and training for your child. If your child has co-existing conditions, particularly ADHD, medications may help significantly improve symptoms. However, medications alone generally aren't used for ODD unless another disorder co-exists.
The cornerstones of treatment for ODD usually include:
- Individual and family therapy.
- Parent-child interaction therapy
- Cognitive problem-solving training
- Social skills training.
- Parent training.
As part of parent training, you may learn how to:
- Give effective timeouts
- Avoid power struggles
- Remain calm and unemotional in the face of opposition
- Recognize and praise your child's good behaviors and positive characteristics
- Offer acceptable choices to your child, giving him or her a certain amount of control
- Establish a schedule for the family
Although some parent management techniques may seem like common sense, learning to use them in the face of opposition isn't easy, especially if there are other stressors at home. Learning these skills will require consistent practice and patience.
Most important in treatment is for you to show consistent, unconditional love and acceptance of your child, even during difficult and disruptive situations. Don't be too hard on yourself.
At home, you can begin chipping away at problem behaviors by practicing the following:
- Recognize and praise your child's positive behaviors.
- Model the behavior you want your child to have.
- Avoid power struggles.
- Set limits and enforce consistent reasonable consequences.
- Set up a routine.
- Build in time together.
- Assign your child a household chore that's essential and that won't get done unless the child does it.
At first, your child probably won't be cooperative or appreciate your changed response to his or her behavior. Expect that you'll have setbacks and relapses, and be prepared with a plan to manage those times. However, with perseverance and consistency, the initial hard work often pays off with improved behavior and relationships.