ODD or Oppositional Defiant Disorder in children is not uncommon. MomJunction has put together a brief on this behavioral disorder, how to identify it, and how to treat or manage a child with this disorder.
What Is Oppositional Defiant Disorder?
By now you would have guessed that ODD makes children defiant to parents and other authority figures. And you are not wrong.
Oppositional defiant disorder is a childhood behavioral disorder that is also characterized by irritable moods and other unacceptable behaviors. It is natural for kids to display this kind of behavior once in a while. But when it becomes a habit and threatens to define the child’s personality, it is a cause for concern. It is not ODD when a child refuses to do something when they don’t know how to do it successfully. It is important to ensure that the child does know how to complete the task/behavior successfully, and is in a resourceful state in which to complete it.
ODD affects both children and adolescents. Research reveals that around one in every 16 children may have ODD, although there is not a lot of information on it. While ODD cannot really be considered a disability, kids with severe ODD are eligible for supplemental security income (SSI) benefits or social security benefits (1) in the US.
[ Read: Social Development In Children ]
What Causes ODD In A Child
There is no one particular reason for the oppositional defiant disorder. However, the child’s genetics and environmental factors may play a role in its development. Research has proved that most children develop these behaviors as a defense mechanism. Children with ODD start behaving how they do to manage their anxiety or uncertainty, owing to significant changes in their life (2).
Signs Of ODD In The Child
Signs and symptoms of ODD appear in children before they are eight. That’s right, your little boy or girl might start displaying challenging behavior even before they enter teenage. However, it might not be easy to determine if the child is simply strong-willed or has ODD.
The Diagnostic and Statistic Manual of Mental Disorders (DSM-5) lists out the signs and symptoms that you should look out for to determine if the child’s behavior is just another tantrum or it is because of ODD. These symptoms are both behavioral and emotional.
- Frequent temper tantrums: The child is almost always angry and loses temper often.
- Irritable moods: Children with ODD are very touchy. They are easily annoyed or affected by what others do.
- Defiant behavior: Consciously and actively refuses to adhere to rules or follow instructions.
- Argumentative: Often argues with adults, especially authority figures such as parents or guardians and teachers.
- Deliberately disrespecting rules and annoying others by questioning rules.
- Shifting blame: Children with ODD do not take responsibility for their actions. They are always looking to blame others.
- Revengeful attitude: They develop resentment quickly and have a spiteful or revengeful attitude towards others.
[ Read: Child Behavioral Problems And Solutions ]
A child can be considered to have ODD if the pattern of extreme negativity, defiance, irritability, and hostility:
- has existed for over six months,
- is constant – not just occasional outbursts,
- is more than normal for the child’s age – it may seem like a mature behavior at times, not just some childish act,
- disrupts the child’s school and family as well,
- is particularly directed towards all and any authority figures – parents, teachers, coaches, etc.
When do you go to a doctor?
It is easy to mistake the ODD behavior in the child as drama or just acting out. Also, your child is unlikely to see his or her behavior as problematic. Because of the disorder, he will turn it around and blame you or his teachers for being unreasonable and unfair.
Regardless of how the child feels, you must take your child to a psychologist or a behavior specialist if you see any of the signs or symptoms mentioned above. Do consider the duration of such behavior before seeking medical advice.
Doctors need a thorough medical history of the child and will ask you a few questions to understand the kid’s behavior. To gather information, the doctor may ask you about the patterns, duration of the behavior, specific examples of how the child’s behavior is disruptive, etc. Questions about the child’s physical health are also raised to see if the behavior is a result of a physical cause.
Diagnosis of ODD is handled by mental health professionals or therapists. They may use tools such as questionnaires to gather detailed information. A proper diagnosis will reveal if the child has developed ODD or is just reacting to a stressful or disruptive atmosphere at home or school.
Do remember that diagnosing ODD can be difficult without open communication. It is imperative you be honest with the healthcare professional about the child’s behavior, the atmosphere at home and school, etc.
ODD And More?
Sometimes, children with ODD may also develop other mental health conditions such as Attention Deficient Hyperactivity Disorder (ADHD), language and learning disorders, anxiety, and mood disorders. This can be revealed during the diagnosis phase. ADHD is the most common health disorder that can co-exist with ODD.
[ Read: ADHD In Children ]
Treatment Options For ODD
Treating ODD involves long-term psychotherapy, combined with training of the children and parents. Unless another behavioral disorder or mental health issue coexists with ODD, medications are not necessarily used. The treatment methods used for one child may differ from those used for another, depending on the severity, the environment that the child is exposed to, and the behavioral symptoms of the child.
Types of treatment for ODD in children include:
- Parent management training programs along with family therapy to teach parents on the best techniques and methods to deal with an ODD child. The therapy is for all the caregivers of the child, including older siblings and teachers.
- Cognitive behavioral therapy to teach the child problem-solving skills. This helps in changing inappropriate behavior and in teaching the child to respond positively to stressful or negative situations and be open to asking for and accepting help.
- Social skills training can help children, especially adolescents, on how to react to their peers positively, and how they can do better in school. These programs are usually held in the natural environment and groups.
- Medication may be prescribed for severe cases of ODD to control the more distressing symptoms and to treat coexisting conditions such as ADHD, anxiety disorder, and mood disorder.
The treatments may also vary for kids of different age groups, and work well when conducted in a natural environment. Ideally, a combination of parent training, school intervention, and individual therapy helps in treating ODD efficiently and quickly.
[ Read: How To Deal With Child Tantrums ]
Parenting A Child With ODD
Raising a child with ODD is not easy. The good news is that over time, ODD gets better with regular treatment and management. Over 67% kids usually become free of all or any ODD symptoms after three years of treatment. Treating the symptoms early on can also prevent the behavior from worsening. In addition to therapy, here are a few ODD management tips that you should follow to help the child get better soon:
- Set non-negotiable rules at home and adhere to them. The defining characteristic of ODD is that the child opposes authority. Children with ODD have a nagging need to control the environment and the people around them. However, giving into that behavior will only make it difficult to bring the child out of it. So, set a few non-negotiable rules in the house and adhere to them at all times. Make sure there are consequences for every rule and enforce them.
- Use a calm voice when speaking to the child. Whether it is giving him the instructions, explaining what to do, or anything else, stay calm and speak calmly. When you are calm, the chances of the child arguing back will be fewer. Also, try and remove situations where they can argue. For instance, if you break the rules, make sure that you bear the consequences as well. That way, they can’t argue about you being unfair.
- Encourage positive behavior consistently. What’s there to oppose when you are praising the child or encouraging him? Also, celebrate and appreciate if your child can control and regulate his or her damaging behaviors successfully. Try to acknowledge a “good try” when the child has been observed to be trying to regulate but may not be completely successful. In the beginning, self-regulation is difficult and good attempts need to be recognized.
- Model the right behavior. You play a major role in shaping the child’s behavior. By modeling the right conduct, such as following instructions, cooperating with others, speaking calmly and handling stress in a positive way, you encourage your child to behave appropriately. You might want to talk out loud the things that you say to yourself to help you stay calm and problem-solve. This helps the child learn self-talk tools that are normally invisible to them.
[ Read: Conduct Disorder In Children ]
Also, a structured environment can help the child stay physically and emotionally healthy. So, create a routine that includes adequate nutrition, exercise, and sleep.
Activities For Kids With ODD
Among the best ways to modify your child’s defiant behavior, activities and games top the charts. Getting your child to partake in these can be difficult, which is why they are usually a part of the therapy. Here are a few activities or exercises that you can try at home.
- Exercise sheets can be a great way to help your child deal with his emotions, especially anger or rage. Using these practice sheets every day will assist the child to learn how to channel his anger or irritability in a positive way.
- Role plays can also be an excellent way to make older children analyze and change their behavior. These role plays can be acted out during individual or group therapy where the child takes over the parent’s role, and the parent takes the child’s role.
- Time-out or cooling down period can teach the child to control his emotions and not react. Every time your child gets defiant and angry, give him a time-out and ask him to talk to you when he calms down.
- Solve problems together to teach the kid collaboration. That will make the kid respect you and also trust you.
- Miss. Opposite / Mr. Opposite is a fun game played by the child and a parent. In this, the child has to do the contrary to what the parent says, and each time they do it right, they score points. The roles are then reversed, and the mother or father becomes Miss or Mr. Opposite.
This can help the child, and the parents look at oppositional behavior in a fun and playful way, rather than a negative way. The idea of the game is to create positive feelings between the parent and child.
[ Read: Ways To Control Anger In Kids ]
Remember that when your child defies you, it is not personal. It is a behavioral disorder that the child has developed due to environmental factors. So, if your child is rude, irritable, and rebellious, he or she is not the problem. The behavior is the problem. Focus on changing the behavior and not the child. That will help you regain control as a parent, an authority figure that the child will learn to respect and love.
If you have any suggestions or tips on managing ODD symptoms in kids, share them here with other moms.
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