Facing a persistent pattern of persistent defiant, aggressive or argumentative behavior? Your defiant child could be developing oppositional defiant disorder. Learn more.
Nothing quite pushes all of your parenting flaws and insecurities into sharp relief as a defiant child. Particularly a publicly defiant child. When you the grown up are met by spit-in-your-eye defiance to the simplest instructions or a clearly reasonable demand, you’re probably thinking “what am I doing wrong?” Or, “It’s not supposed to be like this.”
And, the disapproving looks, comments and unsolicited suggestions from family, friends and the occasional bystander, undoubtedly add fuel to that dumpster fire. Because you know they are thinking something along the same lines: She’s doing it all wrong. She has no idea what she’s doing.
But there’s different kinds of defiance. There’s the garden variety defiant child who more or less responds well to your default parenting techniques. A child who has a level of defiance that’s developmentally appropriate and largely expected, albeit annoying. But then there’s the child who has a dysfunctional level level of defiance. Something that persists and grows in the face of most reasonable parenting strategies. And, it can be a defiance that escalates on a continuum to more serious conduct issues, absent appropriate intervention.
If your child falls close to the ODD spot on the continuum, you need to know that so you have the chance to turn things around before things get worse. Read on to find out exactly what is ODD in children, how to determine if your child has it, and steps that will help improve the situation for you and your family.
What Is ODD?
Oppositional defiant disorder is a childhood behavioral disorder that involves an extended pattern of defiant, uncooperative and argumentative behavior towards authority figures. ODD typically begins in early childhood. It impacts the child’s normal daily functioning and causes problems with relationships, school, and other key areas of life.
Many kids with oppositional defiant disorder have other disorders, as well. For instance, ADHD kids will often be diagnosed with ODD. When another diagnosis is present, it is called a comorbid condition. Common comorbid disorders diagnosed with ODD include:
- Attention deficit hyperactivity disorder (ADHD)
- Anxiety disorders
- Mood disorders, such as depression
- Learning disabilities
Without successful intervention, a defiant child with ODD may progress to a more severe disorder called conduct disorder. Conduct disorder involves serious acts like harming others, stealing and setting fires. And, conduct disorder may continue to progress later in life to antisocial personality disorder. Antisocial personality disorder involves routinely disregarding the rights, feelings and property of others. (These folks are also known as sociopaths.)
Related Content: This Is What You Need To Know About ODD When Parenting An ADHD Child
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What Causes Oppositional Defiant Disorder?
Research suggests that several factors or combination of factors can contribute to the occurrence of ODD in children. These include genetic, biological and environmental factors. Some experts believe that ODD arising in younger children more likely has a genetic component, while later-arising ODD may have more of an environmental basis.
- Genetic – Many kids with oppositional defiant disorder have a family history of other mental health problems, including ADHD, depression, bipolar disorder, and anxiety disorders. Studies have suggested that oppositional defiant disorder shares a common genetic factor with these other disorders, especially ADHD.
- Biological – Researchers have found that deficits or injuries in some regions of the brain can lead to oppositional defiant disorder as well as similar mental disorders. This suggests that biological factors can be present in ODD.
- Environmental – Some of the environmental factors associated with ODD include harsh and inconsistent discipline, absence of adult supervision, severe family dysfunction, parental substance abuse and mental health problems, and child abuse or neglect.
What Are The Signs Of Oppositional Defiant Disorder in Children?
The signs of ODD in children usually start very early in life — as soon as the preschool years. Although symptoms can start later, they almost always begin by the teen years.
Here are some of the symptoms of ODD as described in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). At least four designated symptoms must be present for at least six months to meet the diagnostic criteria for ODD. And, the DSM-5 specifically notes that these interactions occur between the defiant child and someone who is not a sibling.
- Often angry or resentful
- Frequent angry outbursts and lost temper
- Easily annoyed
- Frequently defiant or argumentative with adults
- Blaming others for his or her mistakes
- Deliberately tries to annoy others
- Refusing to comply with adult rules
- Spiteful or vindictive behaviors
- Saying mean or hurtful things to others
- Blaming others for his or her misbehavior
- Verbal aggression towards peers and family members
How is Oppositional Defiant Disorder Diagnosed?
If you’re concerned that your defiant child has a level of defiance that exceeds what’s developmentally appropriate, or that it significantly impairs his functioning at home or school, seek a professional evaluation.
The diagnostic process usually starts with your child’s pediatrician or another physician. The doctor will typically initially conduct a complete medical history and exam to rule out any physical cause for the behavior. Although there are no blood tests that can determine if your child has ODD, the doctor may still run blood tests to rule out medical conditions. Once your child’s doctor has ruled out physical health problems as the cause of the behavioral issues, she will likely refer your child to a mental health specialist, such as a psychiatrist, psychologist or a mental health therapist for an evaluation of oppositional defiant disorder.
Mental health professionals use variety of assessments and interview tools to evaluate ODD in children. The diagnosis is based on the child’s symptoms or observation of the child’s behavior. The mental health specialist may also obtain information from your child’s teachers about your child’s responses in that setting. Symptoms are compared to those described in the DSM-5.
Preparing For Your Appointment
Before your first appointment, take time to jot down some notes that include the following information:
- All of your child’s medications, including dosages. If your child regularly takes herbal supplements, include that information as well.
- Your child’s relevant medical history such as other diagnoses or conditions.
- Information about your child’s behavior issues. What problems or issues have you noticed? When did these problems start? Do they occur outside the home? How often?
- Your child’s school performance, including academic grades. Have your child’s teachers reported similar behaviors at school?
- Note information about an existing IEP or 504 plan, if you have one.
- Any traumatic events or major family disruptions such as a divorce or recent death. Or, other significant changes to family structure such as separation, re-marriage, or introduction of other adults into the home.
- Any other questions or concerns you have.
Questions to Ask
Whether you are seeking an initial consult with your family doctor, or you have been referred to a mental health specialist for evaluation, consider asking the following questions:
- Will you seek information from my child’s school or teachers? If so, how?
- Are there any other causes for the behavior?
- Does my child need to be screened for any other mental health disorders or conditions?
- Do you prescribe medications for co-occurring conditions? If not, can you refer me to a provider who can?
- What can I do at home to help my child?
- What are different treatment options?
- Where can I find support for oppositional defiant disorder? Are there any community support groups that I can join?
Complications of Oppositional Defiant Disorder
If ODD in children is ignored, it can lead to a variety of complications for your child. The following are all linked with oppositional defiant disorder. Treating the condition early can help prevent these problems.
- Poor peer and social interactions
- Increased risk of substance abuse
- Poor school performance
- Severe school discipline such as repeated suspensions or expulsion
- Progression to conduct disorder
- Other mental health problems
- Increased risk of juvenile delinquency or criminal behavior
What Treatments Are Available for A Defiant Child With ODD?
It is essential to get treatment as soon as possible if you suspect that your defiant child might have ODD. The sooner treatment is started, the better. It can reduce the risk of your child developing more serious mental problems like conduct disorder. Early treatment can also help improve your child’s social and educational functioning. As well as the level of peace and happiness in your home.
Here are some of the most common treatments for ODD.
Parent Skills Training
As a parent, you’ll likely play a significant role in your child’s treatment. With ODD, traditional behavioral management techniques often don’t work. Therefore, you’ll have to learn strategies that might be entirely different than those you have used in the past. Parent training programs help you learn how to set clear expectations for behavior and use effective consequences for misbehavior.
Family Therapy
If your child has ODD, it may put a strain on your parent-child relationship. Explosive outbursts, frequent arguments, and ignored commands can lead towards frustration and resentment. Negative interactions between you and your child can also reinforce hostile patterns of behavior making ODD worse. Family therapy helps to strengthen and repair damaged family bonds. It helps promote new, more positive interactions and communication.
Individual Therapy
Individual therapy will help your child develop more effective problem-solving and coping skills. It can help teach your child how to respond to stressful situations in more adaptive ways and how to manage their emotions. Cognitive behavioral therapy (CBT) may be used with older children to teach them how to change their thinking to reduce negative feelings and behaviors.
Medications
Medications are sometimes prescribed by a psychiatrist to help manage symptoms of co-occurring disorders like ADHD or depression. Although these are not explicitly prescribed for ODD, they can sometimes help manage overlapping symptoms of both disorders.
Tips For Managing Oppositional Defiant Disorder At Home
Here are some ways that you can help manage ODD at home:
- Set limits. Give clear, concise instructions. Enforce reasonable, age-appropriate consequences when your child breaks the rules.
- Focus on positive behaviors. Negative attention can feed into ODD. Pay attention to and praise your child’s positive behaviors. Even if you have to start really small. Although you cannot ignore all negative behaviors, such as self-harm, you should try to ignore the ones that you can.
- Maintain consistency. Make sure you have a consistent routine or daily schedule for your child. Stick to the routine as much as possible.
- Avoid power struggles. If you find yourself arguing with your child, then you are engaged in a power struggle. When you are disciplining your child, hand out the consequences and move on. An ODD child will likely try to initiate an argument or dispute about the consequences. Avoid the urge to respond. Just stay firm on your decision.
Two great resources for parents are The Kazdin Method for Parenting the Defiant Child and The Everyday Parenting Toolkit.
Support and Coping For Parents
Parents of ODD kids face a variety of challenges. You are probably dealing with challenging behaviors on a day-to-day basis. You might find it hard to juggle things like doctor’s appointments and school meetings. Plus, it can be daunting to change your parenting style. Don’t hesitate to seek resources to help you cope with the struggles that you face.
- Support Groups – It can be hard to share your struggles with your kid’s behavior with other parents who can’t really relate. So find support and understanding from other parents who are going through something similar. If you are interested in an in-person group, trying doing an internet search for groups in your area. For example, google “oppositional defiant disorder support group + [your city].”
And, you can also find support from similarly situated parents online. Try checking out groups on Facebook (search “oppositional defiant disorder”) or search “oppositional defiant support forum” on google.
- Counseling – You may also benefit from individual counseling for yourself to help you manage stress and learn strategies for coping.
Closing Thoughts:
If you suspect that your child may have ODD, you should seek an evaluation as soon as possible. Early intervention and treatment can lead to significantly improved outcomes, and avoid more serious issues later.
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