Oppositional Defiant Disorder

Introductionresearch on ODD.
Oppositional defiant disorder (ODD) is a psychiatricCo-morbidity
behavior disorder that is characterized byODD is frequently goes along with other disorders.
aggressiveness and a tendency to purposefully50-65% of ODD children also have ADHD. 35% of
bother and irritate others. These behaviors causethese children develop some form of affective
significant difficulties with family and friends and atdisorder. 20% have some form of mood disorder,
school or work.such as depression or anxiety. 15% develop some
Oppositional defiant disorder is sometimes aform of personality disorder. These children
precursor of conduct disorder. Much of thefrequently have learning disorders and academic
literature tends to lump these two conditionsdifficulties.
together. However, they seem to be distinctIf your child has ODD it is important to know
entities and, although conduct disorder does havethere are other co-existing problems. These other
a genetic component, ODD does not.problems usually must be addressed before you
Descriptioncan begin to help your child with ODD.
Oppositional defiant children show a consistentPrognosis
pattern of refusing to follow commands orSo what happens to these children? There are
requests by adults. These children repeatedly losefour possible paths.
their temper, argue with adults, and refuse to1. Some will grow out of it. Half of the
comply with rules and directions. They are easilypreschoolers that are labeled ODD are normal by
annoyed and blame others for their mistakes.the age of 8. However, in older ODD children,
Children with ODD show a pattern of75% will still fulfill the diagnostic criteria later in life.
stubbornness and frequently test limits, even in2. The ODD may turn into something else. 5-10 %
early childhood.of preschoolers with ODD have their diagnosis
These children can be manipulative and oftenchanged from ODD to ADHD. In some children,
induce discord in those around them. Commonlythe defiant behavior gets worse and these
they can incite parents and other family memberschildren eventually are diagnosed with Conduct
to fight with one and other rather than focus onDisorder. This progression usually happens fairly
the child, who is the source of the problem.early. If a child has ODD for 3-4 years and he
Behavioral Symptomshasn't developed Conduct Disorder, then he won't
Common behaviors seen in oppositional defiantever develop it.
disorder include:3. The child may continue to have ODD without
- Losing one's temperany thing else. This is unusual. By the time
- Arguing with adultspreschoolers with ODD are 8 years old, only 5%
- Actively defying requestshave ODD and nothing else.
- Refusing to follow rules4. The child develops other disorders in addition to
- Deliberately annoying other peopleODD. This is very common.
- Blaming others for one's own mistakes orTreatment
misbehaviorMost of these children have some other disorder
- Being touchy, easily annoyedalong with their ODD. Treating this other disorder
- Being easily angered, resentful, spiteful, oris the key to proper ODD management. This
vindictive.frequently means giving medication. Although this
- Speaking harshly, or unkind when upsettype of medical intervention does not make the
- Seeking revengechildren "normal", it can make a big difference. It
- Having frequent temper tantrumsoften allows other non-medical interventions to
Many parents report that their ODD children werework much better.
rigid and demanding from an early age.For example, if a child has both ODD and ADHD,
Normal children, especially around the ages or 2 orthen giving the child Ritalin may have a significant
3 or during the teenage years display most ofeffect on his ODD, also. This positive effect does
these behaviors from time to time. When childrennot seem to be related to the severity of the
are tired, hungry, or upset, they may be defiant.ADHD. That means even if the child has mild
However, children with oppositional defiantADHD and could do without Ritalin, if he is treated
disorder display these behaviors more frequentlymedically, you might see an improvement in his
and to the extent that they and interfere withODD.
learning, school adjustment, and, sometimes, withOnce the other problems are under control, the
the child's social relationships.best treatment for ODD is parent training. In a
Diagnosisstudy published in 1998, eighty-two research
The diagnosis of ODD is not always straightstudies were evaluated were examined for
forward and needs to be made by a psychiatristefficacy. Approaches focusing on parent training
or some other qualified mental health professionalwere the most affective techniques.
after a comprehensive evaluation. The child mustThe main point is that some parent-training
be evaluated for other disorders as well sinceprogram is essential in addressing ODD. This is not
ODD usually does not come alone. If the child hasgoing to work for everyone, but it is the best
ADHD, mood disorders, or anxiety disorders,treatment that we have available for ODD.
these other problems must be addressed beforeAdvice to Parents
you can begin to work with the ODD.That is with regard to your child. If your child has
If you feel your child may have ODD, there is aODD you need to take care of yourself, also. No
quick screening test. Go to:child needs a martyr as a parent.
CausesHere are some of the things you can do:
What is the cause of ODD? The real answer is- Maintain interests other than your child with
that nobody knows. However, since as scientistODD. You have to be a person.
we hate to admit this, we have currently have- Try to work with and obtain support from the
two theories.other adults (teachers, coaches, and spouse)
The developmental theory proposes that ODD isdealing with your child.
really a result of incomplete child development. For- Take time to work on your relationship with
some reason, these children never complete theyour spouse. Raising these children is very difficult
developmental tasks that normal children learn toand can put a strain on the best of marriages.
master during the toddler years.- Manage your own stress with exercise and
The learning theory suggests that ODD comes asrelaxation.
a response to negative interactions. The- Take frequent vacations. This is a must.
techniques used by parents and authority figuresConclusion
on these children bring about the oppositionalIt is tough to live with children who have ODD.
defiant behavior.What is worse is that there does not seem to be
ODD is the most common psychiatric diagnosis inany cure. However, if you make sure that your
children and it usually persists into adulthood. Onechild has his other problems addressed and you
would think a lot of research would be done onimprove your parenting skills by enrolling in a
this condition. That is not the case. While thereparent training program, you can do a great deal
are hundreds of research studies on ADHD andto improve your child's condition and your own.
childhood mood disorders, there is very little