Oppositional Defiant Disorder (ODD)

All kids go through difficult stages and could sometimes be described as "oppositional." There is an enormous difference between the normal defiance seen in two year olds (they don't call it the 'terrible twos' for nothing!) and the early teen years though and the chronic condition referred to as Oppositional Defiant Disorder (ODD).

What is Oppositional Defiant Disorder?

Unlike behavioural issues in older kids and teens, ODD is typically seen in children younger than nine or ten years. A diagnosis of ODD requires that the child is defiant and disobedient, with a provocative quality to their behaviour. It is also important to note that in ODD, the severity of symptoms is not such as to include extremely dissocial or aggressive behaviour that is harmful or illegal. Tendencies toward cruelty or angry, violent aggression are not symptomatic of Oppositional Defiant Disorder and should be reported to the GP so that a correct diagnosis can be made and an appropriate treatment plan can be implemented.

Symptoms of ODD

While parents shouldn't rush to the conclusion that their stubborn, sometimes defiant child has ODD, there are symptoms that may warrant a professional evaluation. Children with ODD are likely to act out in a number of situations, with school and home being the two places where behaviours are deemed most disruptive. Occasional emotional outbursts are considered a normal part of childhood, but if parents notice an ongoing pattern of the following behaviours, especially if the child's actions cause them difficulty in everyday functioning, a thorough evaluation is recommended:

• Frequent and/or extreme temper tantrums
• Tendency to be easily annoyed by others
• Blatant refusal to comply with household or school rules
• Takes argumentative stance with adults
• Rude, uncooperative and confrontational attitude
• Use of mean-spirited language when upset
• Deliberate attempts to upset and annoy others
• Frequent bursts of anger or resentful attitude
• Tendency to place blame on others
• Outward and belligerent defiance
• Revengeful attitude

A professional evaluation can be of great assistance since it can be very difficult for parents to ascertain the root causes of their children's troubling behaviours. Additionally, children with other conditions, such as Attention Deficit Disorder (ADD), anxiety issues, mood disorders (including depression or bipolar disorder), or learning disabilities may exhibit similar symptoms, making diagnosis by an untrained parent especially difficult.

Causes of Oppositional Defiant Disorder

There is much speculation about the causes of ODD, with no definitive answers at this time. Many parents of kids with Oppositional Defiant Disorder do report that those children were rigid and demanding from an early age, compared to their siblings, raising the possibility that there may be biological or environmental factors involved. Some studies seem to indicate a tendency for ODD to run in families, strengthening the argument for a biological connection. While the causes are still a bit of a mystery, treatment options are well-established.

Treatment Options

A number of treatment options have proven effective for the management of ODD. It is vital that parents are actively involved in their child's struggle to control inappropriate and troubling behaviours, so attending a parent training program can be quite helpful. Additionally, family psychotherapy may be beneficial in helping improve communication as the child attends individual therapy sessions to learn anger management techniques. Cognitive behavioural therapy and social skills training classes may be needed to help kids with ODD increase their problem solving skills while learning to interact more positively with peers and authority figures. All of this can be difficult on parents, who often feel helpless and discouraged. Actively taking measures to help their children cope and function can be empowering for parents, making life easier for the whole family:

• Offer children praise and encouragement when they are cooperative.
• Parents should refrain from arguing with children and make it clear that they will not be engaged in confrontational displays.
• Establish reasonable and age-appropriate behavioural expectations and be consistent in following up with consequences for disobedience.
• Parents should learn and utilise stress management techniques. This will not only help them to cope with the pressures of raising a child with ODD, but will also provide good examples for their children.