| About a year ago I wrote an article on | | | | Disorder at This progression usually happens fairly |
| Oppositional Defiant Disorder discussing the | | | | early. If a child has ODD for 3-4 years and he |
| condition, symptoms and treatment options. This | | | | hasn't developed Conduct Disorder, then he won't |
| article is an update describing what is new. | | | | ever develop it. |
| -Introduction | | | | - The child may continue to have ODD without |
| Oppositional defiant disorder (ODD) is a psychiatric | | | | any thing else. This is unusual. By the time |
| behavior disorder that is characterized by | | | | preschoolers with ODD are 8 years old, only 5% |
| aggressiveness and a tendency to purposefully | | | | have ODD and nothing else. |
| bother and irritate others. These behaviors cause | | | | - The child develops other disorders in addition to |
| significant difficulties with family and friends and at | | | | ODD. This is very common. |
| school or work. | | | | -Treatment: Medical Intervention |
| -Description | | | | There have been some recent studies that have |
| Oppositional defiant children show a consistent | | | | examined the effects of certain medications on |
| pattern of refusing to follow commands or | | | | Oppositional Defiant Disorder. All the research is |
| requests by adults. These children repeatedly lose | | | | preliminary and just suggests that certain |
| their temper, argue with adults, and refuse to | | | | treatments may help. |
| comply with rules and directions. They are easily | | | | One study examined the use of Ritalin to treat |
| annoyed and blame others for their mistakes. | | | | children with both ADHD and ODD. This study |
| Children with ODD show a pattern of | | | | found that 90% of the children treated with Ritalin |
| stubbornness and frequently test limits, even in | | | | no longer had the ODD by the end of the study. |
| early childhood. | | | | The researchers skewed the results a bit |
| These children can be manipulative and often | | | | because a number of children were dropped from |
| induce discord in those around them. Commonly | | | | the study because they wouldn't comply with the |
| they turn attention away from themselves by | | | | treatment regimen. Still if these children are |
| inciting parents and other family members to fight | | | | included as treatment failures the study still |
| with one and other. | | | | showed a 75% success rate. |
| -Behavioral Symptoms | | | | There have been two studies examining the |
| Normal children occasionally have episodes of | | | | effect of Strattera on children with both ADHD |
| defiant behavior, particularly during ages of | | | | and ODD. One study showed that Strattera |
| transition such as 2 to 3 or the teenage years | | | | helped with ODD, one study showed it did not |
| where the child uses defiance in an attempt to | | | | help. |
| assert himself. Children who are tired, hungry, or | | | | There was a large Canadian study that showed |
| upset may be defiant. Oppositional defiant | | | | that Risperdal helped with aggressive behavior in |
| behavior is a matter of degree and frequency. | | | | children with below normal intelligence. It did not |
| Children with Oppositional Defiant Disorder display | | | | matter if the child had ADHD or not. |
| difficult behavior to the extent that it can | | | | There was study showing that 80% of children |
| interfere with learning, school adjustment, and, | | | | with explosive behavior improved when given the |
| sometimes, with the child's social relationships. | | | | mood stabilizer, divalproex. |
| Common behaviors seen in Oppositional Defiant | | | | There was another pilot study examining the use |
| Disorder include: | | | | of Omega-3 oils and vitamin E in ODD children. |
| - Losing one's temper | | | | Both helped the ODD behavior to some degree. |
| - Arguing with adults | | | | -Treatment: Psychological Intervention |
| - Actively defying requests | | | | Parent management training is still viewed as the |
| - Refusing to follow rules | | | | main treatment for Oppositional Defiant Disorder. |
| - Deliberately annoying other people | | | | Our program, How to Improve Your Child's |
| - Blaming others for one's own mistakes or | | | | Behavior, located at which is available online, or |
| misbehavior | | | | some other parent training program is still |
| - Being touchy, easily annoyed | | | | considered essential if you want to help your child. |
| - Being easily angered, resentful, spiteful, or | | | | Also, the younger your child is when you enroll in |
| vindictive. | | | | such a program, the better the results. |
| - Speaking harshly, or unkind when upset | | | | -Conclusion: Advice to Parents |
| - Seeking revenge | | | | Currently, there is still far too little research on |
| - Having frequent temper tantrums | | | | this very common disorder. |
| Many parents report that their ODD children were | | | | Medically, the most important consideration is to |
| rigid and demanding from an early age. | | | | treat other disorders that come along with ODD. |
| -Diagnosis | | | | Considering that Ritalin may help alleviate the |
| The diagnosis of ODD is not always straight | | | | problem in 75-90% of ODD children who have |
| forward and needs to be made by a psychiatrist | | | | ADHD, and considering that most children with |
| or some other qualified mental health professional | | | | ODD also have some degree of ADHD, I feel that |
| after a comprehensive evaluation. | | | | it is very worth your while to try your ODD child |
| If you feel your child may have ODD, there is a | | | | on Ritalin unless you know for sure that he does |
| quick ODD Screening Test at | | | | not have ADHD. The other treatments may also |
| -Causes | | | | be worth a try depending upon the nature of |
| It is not clear what causes Oppositional Defiant | | | | your child. |
| Disorder. There are currently two theories. | | | | I feel that using Omega-3 supplements and a |
| The developmental theory suggests that ODD is | | | | vitamin E supplement should be tried in all children. |
| really a result of incomplete development. For | | | | This is because most children are deficient in |
| some reason, ODD children never complete the | | | | these nutrients. Even if it does not help with the |
| developmental tasks that normal children master | | | | ODD, it should make your child healthier. |
| during the toddler years. They get stuck in the | | | | Parent training is still the most effective means of |
| 2-3 year old defiant stage and never really grow | | | | dealing with Oppositional Defiant Disorder. The two |
| out of it. | | | | main drawbacks of most of these programs are |
| The learning theory suggests that Oppositional | | | | the expense and the availability. |
| Defiant Disorder comes as a response to | | | | Some practitioners charge $100 or more per visit |
| negative interactions. The techniques used by | | | | and considering the program will take several |
| parents and authority figures on these children | | | | months costs add up. Insurance usually will not |
| bring about the oppositional defiant behavior. | | | | pay for such programs. Many parents complain to |
| -Co-morbidity | | | | me that they can not afford the program that |
| Oppositional Defiant Disorder usually does not | | | | their child so desperately needs. |
| occur alone. | | | | In addition, these programs are not available |
| 50-65% of ODD children also have: | | | | everywhere. Over the years, numerous parents |
| - ADD ADHD | | | | have told me that where they live there are no |
| - 35% of these children develop some form of | | | | programs for Oppositional Defiant Children. |
| affective disorder | | | | I created How to Improve Your Child's Behavior |
| - 20% have some form of mood disorder, such | | | | to address these two problems. It allows parents |
| as | | | | to help their children regardless of where they live |
| - Bipolar Disorder or anxiety | | | | and at a cost that is less than one office visit. |
| - 15% develop some form of personality disorder | | | | Even though it was an experiment to try to |
| - Many of these children have learning disorders | | | | administer such a program online and to date no |
| Any child with Oppositional Defiant Disorder must | | | | one else is doing this, over the past two years |
| be evaluated for other disorders as well. If your | | | | How to Improve Your Child's Behavior has proven |
| child has ODD it is imperative to find out what are | | | | time and again to help parents gain control of their |
| the co-existing problems. This is the key to | | | | defiant children. |
| treating the condition, as we shall soon discuss. | | | | Get more information on Oppositional Defiant |
| -Prognosis | | | | Disorder- ODD Help at |
| So what happens to these children? There are | | | | It is tough to live with children who have ODD. |
| four possible paths. | | | | However, if you make sure that your child has his |
| - Some will grow out of it. Half of the | | | | other problems addressed and you improve your |
| preschoolers that are labeled ODD are normal by | | | | parenting skills by enrolling in a parent training |
| the age of 8. However, in older ODD children, | | | | program, you can do a great deal to improve |
| 75% will still fulfill the diagnostic criteria later in life. | | | | your child's condition and his future. |
| - The ODD may turn into something else. 5-10% | | | | Anthony Kane, MD |
| of preschoolers with ODD have their diagnosis | | | | ADD ADHD Advances |
| changed from ODD to ADHD. In some children, | | | | Attention Publishers: |
| the defiant behavior gets worse and these | | | | This article is available for your website or ezine. |
| children eventually are diagnosed with Conduct | | | | |