| Introduction | | | | research studies on ADHD and childhood mood |
| | | | disorders, there is very little research on |
| Oppositional defiant disorder (ODD) is a | | | | ODD. |
| psychiatric behavior disorder that is | | | | |
| characterized by aggressiveness and a | | | | Co-morbidity |
| tendency to purposefully bother and irritate | | | | |
| others. These behaviors cause significant | | | | ODD is frequently goes along with other |
| difficulties with family and friends and at | | | | disorders. 50-65% of ODD children also have |
| school or work. | | | | ADHD. 35% of these children develop some |
| | | | form of affective disorder. 20% have some |
| Oppositional defiant disorder is sometimes a | | | | form of mood disorder, such as depression or |
| precursor of conduct disorder. Much of the | | | | anxiety. 15% develop some form of |
| literature tends to lump these two | | | | personality disorder. These children |
| conditions together. However, they seem to | | | | frequently have learning disorders and |
| be distinct entities and, although conduct | | | | academic difficulties. |
| disorder does have a genetic component, ODD | | | | |
| does not. | | | | If your child has ODD it is important to know |
| | | | there are other co-existing problems. These |
| Description | | | | other problems usually must be addressed |
| | | | before you can begin to help your child with |
| Oppositional defiant children show a | | | | ODD. |
| consistent pattern of refusing to follow | | | | |
| commands or requests by adults. These | | | | Prognosis |
| children repeatedly lose their temper, argue | | | | |
| with adults, and refuse to comply with rules | | | | So what happens to these children? There are |
| and directions. They are easily annoyed and | | | | four possible paths. |
| blame others for their mistakes. Children | | | | |
| with ODD show a pattern of stubbornness and | | | | 1. Some will grow out of it. Half of the |
| frequently test limits, even in early | | | | preschoolers that are labeled ODD are normal |
| childhood. | | | | by the age of 8. However, in older ODD |
| | | | children, 75% will still fulfill the |
| These children can be manipulative and often | | | | diagnostic criteria later in life. |
| induce discord in those around them. | | | | |
| Commonly they can incite parents and other | | | | 2. The ODD may turn into something else. |
| family members to fight with one and other | | | | 5-10 % of preschoolers with ODD have their |
| rather than focus on the child, who is the | | | | diagnosis changed from ODD to ADHD. In some |
| source of the problem. | | | | children, the defiant behavior gets worse and |
| | | | these children eventually are diagnosed with |
| Behavioral Symptoms | | | | Conduct Disorder. This progression usually |
| | | | happens fairly early. If a child has ODD for |
| Common behaviors seen in oppositional defiant | | | | 3-4 years and he hasn't developed Conduct |
| disorder include: | | | | Disorder, then he won't ever develop it. |
| | | | |
| - Losing one's temper | | | | 3. The child may continue to have ODD without |
| | | | any thing else. This is unusual. By the |
| - Arguing with adults | | | | time preschoolers with ODD are 8 years old, |
| | | | only 5% have ODD and nothing else. |
| - Actively defying requests | | | | |
| | | | 4. The child develops other disorders in |
| - Refusing to follow rules | | | | addition to ODD. This is very common. |
| | | | |
| - Deliberately annoying other people | | | | Treatment |
| | | | |
| - Blaming others for one's own mistakes or | | | | Most of these children have some other |
| misbehavior | | | | disorder along with their ODD. Treating this |
| | | | other disorder is the key to proper ODD |
| - Being touchy, easily annoyed | | | | management. This frequently means giving |
| | | | medication. Although this type of medical |
| - Being easily angered, resentful, spiteful, | | | | intervention does not make the children |
| or vindictive. | | | | "normal", it can make a big difference. It |
| | | | often allows other non-medical interventions |
| - Speaking harshly, or unkind when upset | | | | to work much better. |
| | | | |
| - Seeking revenge | | | | For example, if a child has both ODD and |
| | | | ADHD, then giving the child Ritalin may have |
| - Having frequent temper tantrums | | | | a significant effect on his ODD, also. This |
| | | | positive effect does not seem to be related |
| Many parents report that their ODD children | | | | to the severity of the ADHD. That means even |
| were rigid and demanding from an early age. | | | | if the child has mild ADHD and could do |
| | | | without Ritalin, if he is treated medically, |
| Normal children, especially around the ages | | | | you might see an improvement in his ODD. |
| or 2 or 3 or during the teenage years display | | | | |
| most of these behaviors from time to time. | | | | Once the other problems are under control, |
| When children are tired, hungry, or upset, | | | | the best treatment for ODD is parent |
| they may be defiant. However, children with | | | | training. In a study published in 1998, |
| oppositional defiant disorder display these | | | | eighty-two research studies were evaluated |
| behaviors more frequently and to the extent | | | | were examined for efficacy. Approaches |
| that they and interfere with learning, school | | | | focusing on parent training were the most |
| adjustment, and, sometimes, with the child's | | | | affective techniques. |
| social relationships. | | | | |
| | | | The main point is that some parent-training |
| Diagnosis | | | | program is essential in addressing ODD. This |
| | | | is not going to work for everyone, but it is |
| The diagnosis of ODD is not always straight | | | | the best treatment that we have available for |
| forward and needs to be made by a | | | | ODD. |
| psychiatrist or some other qualified mental | | | | |
| health professional after a comprehensive | | | | Advice to Parents |
| evaluation. The child must be evaluated for | | | | |
| other disorders as well since ODD usually | | | | That is with regard to your child. If your |
| does not come alone. If the child has ADHD, | | | | child has ODD you need to take care of |
| mood disorders, or anxiety disorders, these | | | | yourself, also. No child needs a martyr as a |
| other problems must be addressed before you | | | | parent. |
| can begin to work with the ODD. | | | | |
| | | | Here are some of the things you can do: |
| If you feel your child may have ODD, there is | | | | |
| a quick screening test. Go to: | | | | - Maintain interests other than your child |
| | | | with ODD. You have to be a person. |
| Causes | | | | |
| | | | - Try to work with and obtain support from |
| What is the cause of ODD? The real answer is | | | | the other adults (teachers, coaches, and |
| that nobody knows. However, since as | | | | spouse) dealing with your child. |
| scientist we hate to admit this, we have | | | | |
| currently have two theories. | | | | - Take time to work on your relationship with |
| | | | your spouse. Raising these children is very |
| The developmental theory proposes that ODD is | | | | difficult and can put a strain on the best of |
| really a result of incomplete child | | | | marriages. |
| development. For some reason, these | | | | |
| children never complete the developmental | | | | - Manage your own stress with exercise and |
| tasks that normal children learn to master | | | | relaxation. |
| during the toddler years. | | | | |
| | | | - Take frequent vacations. This is a must. |
| The learning theory suggests that ODD comes | | | | |
| as a response to negative interactions. The | | | | Conclusion |
| techniques used by parents and authority | | | | |
| figures on these children bring about the | | | | It is tough to live with children who have |
| oppositional defiant behavior. | | | | ODD. What is worse is that there does not |
| | | | seem to be any cure. However, if you make |
| ODD is the most common psychiatric diagnosis | | | | sure that your child has his other problems |
| in children and it usually persists into | | | | addressed and you improve your parenting |
| adulthood. One would think a lot of research | | | | skills by enrolling in a parent training |
| would be done on this condition. That is not | | | | program, you can do a great deal to improve |
| the case. While there are hundreds of | | | | your child's condition and your own. |