Oppositional defiant disorder (ODD) often occurs along with other behavioral or mental health problems such as attention-deficit/hyperactivity disorder (ADHD), anxiety or depression. ODD is a behavior disorder, usually diagnosed in childhood, that is characterized by uncooperative, defiant, negativistic, irritable, and annoying behaviors toward parents, peers, teachers, and other authority figures.

ODD is reported to affect between 10 percent and 15 percent of children and adolescents in the general population. ODD is diagnosed when a child displays a persistent or consistent pattern of defiance, disobedience, and hostility toward various authority figures including parents, teachers, and other adults. Oppositional defiant disorder is sometimes a precursor of conduct disorder (DSM-IV).

Signs and symptoms

Symptoms of ODD may include: frequent temper tantrums excessive arguing with adults active defiance and refusal to comply with adult requests and rules deliberate attempts to annoy or upset people blaming others for his or her mistakes or misbehavior often being touchy or easily annoyed by others frequent anger and resentment mean and hateful talking when upset seeking revenge.

Research

Researchers have postulated that, in some children, ODD may be the developmental precursor of conduct disorder. Research indicates that these patterns are established early, in the child’s preschool years; left untreated, pattern development accelerates, and patterns worsen. Research also shows that some cases of conduct disorder begin in early childhood, often by the preschool years. Research evidence is lacking on whether the distinction is qualitative or quantitative.

Research has shown that parent management training is more effective than family therapy. Research suggests that all things being equal, girls with ODD with ADHD have significantly worse social problems than boys with ODD with ADHD. Researchers have documented that parents who have been diagnosed with antisocial personality disorder (APD) or exhibit the signs of this disorder are strongly and specifically linked back to ODD in early childhood and conduct disorder (CD) in late childhood and in the adolescent years.

Causes

The causes of ODD are unknown, but many parents report that their child with ODD was more rigid and demanding than the child’s siblings from an early age. The disturbance in behavior causes clinically significant impairment in social, academic, or occupational functioning. Many causes of Attention-Deficit/Hyperactivity Disorder have been studied, but no one cause seems to apply to all young people with the disorder.

Parenting

Parents can help their child with ODD in the following ways: Always build on the positives, give the child praise and positive reinforcement when he shows flexibility or cooperation. Parents may ask their pediatrician or family physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat ODD and any coexisting psychiatric condition.

Parents who note symptoms of ODD in their child or teen can help by seeking an evaluation and treatment early. Parents need support and understanding as well as developing more effective parenting approaches.

Teachers

Teachers can be great allies in keeping your child with Oppositional Defiant Disorder safe and successful in school, but you’ll need to make sure they have all the knowledge they need to help. Try to work with and obtain support from the other adults (teachers, coaches, and spouse) dealing with your child.

By the time they are school aged, children with patterns of oppositional behavior tend to express their defiance with teachers and other adults, and they exhibit aggression toward their peers. When behavioral difficulties are present beginning in the preschool period, teachers and families may overlook significant deficiencies in the child’s learning and academic performance. A detailed history of the child’s behavior from parents and teachers, clinical observations of the child’s behavior, and, sometimes, psychological testing contribute to the diagnosis.

Diagnosis

The diagnosis of ODD is not always straight forward and needs to be made by a psychiatrist or some other qualified mental health professional after a comprehensive evaluation. Diagnosis is complicated by relatively high rates of comorbid, disruptive, behavior disorders. Diagnosis involves detailed interviews with the child (if they are old enough), parents and teachers, and comparing the child’s behaviour with a checklist for ODD contained in the Diagnostic and Statistical Manual of Mental Disorders from the American Psychiatric Association.

Therapy

Therapy can provide a consistent daily schedule, support, consistent rules, discipline, and limits. Therapy can occur in residential, day treatment, or medical settings.

Treatment

Treatment is conducted primarily with the parents; the therapist demonstrates specific procedures to modify parental interactions with their child. Treatment sessions provide the parents with opportunities to practice and refine the techniques. Treatment effects have been stronger with younger children, especially in those with less severe problems. Treatment of all medical, neurological and psychiatric conditions by the appropriate caregivers can improve self-esteem and self-control. Treatment options include parent management training and family therapy.

Treatment can help restore your child’s self-esteem and rebuild a positive relationship between you and your child. Treatment of ODD may include: Parent Training Programs to help manage the child’s behavior, Individual Psychotherapy to develop more effective anger management, Family Psychotherapy to improve communication, Cognitive-Behavioral Therapy to assist problem solving and decrease negativity, and Social Skills Training to increase flexibility and improve frustration tolerance with peers.

Mark Huttenlocker, M.A. is a family therapist who works with parents of strong-willed, out-of-control teens and preteens. If your child is out-of-control and you’re at your wits end, then feel free to use Mark as your own personal parent-coach. Get permanent solutions to your child’s behavior problems within 15 seconds from now by visiting his website: My Out Of Control Teen!