18.11.07

My ODD Child

All children are oppositional from time to time, particularly when tired, hungry, stressed or upset. They may argue, talk back, disobey, and defy parents, teachers, and other adults. Oppositional behavior is often a
normal part of development for two to three year olds and early adolescents. However, openly uncooperative and hostile behavior becomes a serious concern when it is so frequent and consistent that it stands out when compared with other children of the same age and developmental level and when it affects the child’s social, family, and academic life.

In children with Oppositional Defiant Disorder (ODD), there is an ongoing pattern of uncooperative, defiant, and hostile behavior toward authority figures that seriously interferes with the youngster’s day to day functioning.

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


The symptoms are usually seen in multiple settings, but may be more noticeable at home or at school. Five to fifteen percent of all schoolage children have ODD. 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. Biological and environmental factors may have a role.

A child presenting with ODD symptoms should have a comprehensive evaluation. It is important to look for other disorders which may be present; such as, attention deficit hyperactive disorder (ADHD), learning
disabilities, mood disorders (depression, bipolar disorder) and anxiety disorders. It may be difficult to improve the symptoms of ODD without treating the coexisting disorder. Some children with ODD may go on to
develop conduct disorder.

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
  • Social Skills Training to increase flexibility and improve
    frustration tolerance with peers


A child with ODD can be very difficult for parents. These parents need support and understanding. 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.
  • Take a time-out or break if you are about to make the conflict
    with your child worse, not better. This is good modeling for
    your child. Support your child if he decides to take a time-
    out to prevent overreacting.
  • Pick your battles. Since the child with ODD has trouble
    avoiding power struggles, prioritize the things you want your
    child to do. If you give your child a time-out in his room for
    misbehavior, don’t add time for arguing. Say “your time will
    start when you go to your room.”
  • Set up reasonable, age appropriate limits with consequences
    that can be enforced consistently.
  • Maintain interests other than your child with ODD, so that
    managing your child doesn’t take all your time and energy.
    Try to work with and obtain support from the other adults
    (teachers, coaches, and spouse) dealing with your child.
  • Manage your own stress with exercise and relaxation. Use
    respite care as needed.
  • Many children with ODD will respond to the positive
    parenting techniques. 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.

Children with ODD need to learn to take responsibility for their behavior and not use their diagnosis or disability as an excuse for inappropriate behavior. They need help learning how to:

  • Set limits
  • Curb sibling fighting
  • Stop defiance, back-talking, lying and cursing
  • Defuse explosive outbursts and uncontrolled anger
  • Stay on task
  • Do homework and chores
  • Effective problem solving techniques


If their “acting out” has carried on for a long period of time and goes against what is socially acceptable, then your teen probably has a behavioral disorder. If your teen is self-destructive and adversely affects your family, then his or her behavior is clearly a problem.

The causes of ODD are unknown, but many parents report that their ODD child was more rigid and demanding than the child’s siblings from an early age. The symptoms are usually seen in
multiple settings, but may be more noticeable at home or at school. Five to fifteen percent of all schoolage children have ODD. Biological and environmental factors may have a role.

Oppositional defiant disorder appears to be more common in families where at least one parent has a history of a mood disorder, conduct disorder, attention deficit/hyperactivity disorder,
antisocial personality disorder, or a substance-related disorder.

Oppositional Defiant Disorder does not occur alone:

  • 50-65% of ODD children also have ADD/ADHD
  • 35% of these children develop some form of affective disorder
  • 20% have some form of mood disorder, such as Bipolar
    Disorder or anxiety
  • 15% develop some form of personality disorder
  • Many of these children have learning disorders

Teens with ODD plus ADHD are much more difficult to live with. Their destructive and disagreeable behavior are purposeful. They like to push their parents anger-buttons. Every request ends up as a power struggle. Lying becomes a daily habit. Getting a reaction
out of others is amusing to them. They are rarely sorry for the hurtful things they say and do. And they believe nothing is their fault.

Parenting strategies often include a home rules contract (i.e., a written set of expectations that parents have of their teens and preteens). The contract includes basic rules, consequences and
privileges.

The primary purpose of a home rules contract is for teens to be held accountable for their behavior while allowing parents to maintain a reasonable amount of control (i.e., teaching teens that there are consequences for breaking rules, the knowledge of which hopefully will transfer in the teen’s mind to school rules as well as the legal system).

Mark Hutten, M.A., author of My Out-of-Control Child

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