Oppositional Defiant Disorder In Children: How To Spot It?

 

Every child and adolescent reacts to difficult situations in their own way according to different factors. Some of them may include: character, genetics, education and culture. However, when the reaction is not functional, is excessive, constant and affects several aspects of the kid’s relationship with the environment (home, school or other scenarios) we might consider it a problem. That is the case of the Oppositional Defiant Disorder. Here’s some important information about this behavioral disorder.

What is the Oppositional Defiant Disorder?

The Oppositional Defiant Disorder (ODD) is defined by the National Institute of Health as “a persistent pattern of defiant, disobedient and hostile behavior towards authority figures; a frequent loss of temper, arguing, becoming angry or vindictive, or other negative behaviors”.

In addition, ODD belongs to the group of Disruptive Behavior Disorders (DBD). Children or adolescents experiencing this disorder have a tendency to disrupt or disturb those around them and the environment they live in. Very often they rebel and have arguments with adults, refusing to obey. Moreover, they might even develop a lack of self control, having tantrums and behaving verbally aggressive towards parents and teachers.

Oppositional Defiant Disorder in children

Children with ODD have hostile behavior towards authority

What are the causes of ODD?

The exact cause of this disorder is still unknown. Nonetheless, experts have found biological, psychological and social risk factors. The combination of these three influence the development of ODD.

  • Some biological factors include:
    1. Having a parent with a history of ADHD, ODD, CD or mood disorder
    2. A parent presenting substance abuse problems
    3. Having a mother who smoked during pregnancy
    4. Impairment on the part of the brain in charge of judgement, reasoning and impulse control
    5. Brain-chemical imbalance
  • Psychological factors involved:
    1. Neglectful or absent parent/s
    2. Poor relationship with a parent/s
  • Social risk factors implicated:
    1. Poverty
    2. Neglect
    3. Abuse
    4. Disorganized or chaotic environment
    5. Inconsistent discipline
Oppositional Defiant Disorder in children

Parental relationship involved in ODD

ODD symptoms

When should you start worrying about your children suffering from ODD? How to differentiate between bad mood or a regular tantrum and a disorder? While it may be hard for you to consider that your child might have a behavioral disorder, it’s a crucial part of helping them overcome it. How can you tell if your child needs help?

The behavioral symptoms that must be taken into account in order to recognize oppositional defiant disorder include:

  • Having frequent tantrums
  • Deliberately attempting to blame others for his or her actions or mistakes
  • Arguing excessively with authority figures: parents, teachers, caregivers, etc.
  • Talking in a mean and hateful manner when angry
  • Spiteful or vindictive attitude
  • Refusing to cooperate or comply with requests and rules
  • Questioning the rules regularly
  • Annoying or upsetting others intentionally

Many children start showing symptoms in late preschool or early school age. In general, more boys than girls have this disorder, but in school-age children and adolescents it develops evenly in both boys and girls.

Oppositional Defiant Disorder

How to spot ODD

How and when to diagnose ODD?

As mentioned before, not every tantrum or argument with your kid means he or she has Oppositional Defiant Disorder. Therefore, to diagnose a child, he or she must present an extreme ongoing pattern of hostility, aggressiveness and defiance. The symptoms must be persistent for, at least, 6 months. Also, this aggressiveness is always directed towards an authority figure, is excessive compared to the child’s age and disruptive at home and/or school. In order for the symptoms to lead to a ODD diagnosis, they should not be better described by other conditions such as ADHD, learning disabilities and mood or anxiety disorders.

Furthermore, when a parent starts doubting wether their child might presents ODD, it’s important to seek professional advice (read more about the difference between a psychologist and psychiatrist). Sometimes it’s difficult to spot the symptoms and  some parents might want to wait to see if the child grows out of the phase. Nevertheless, the sooner the treatment starts, the better for the child to overcome the disorder.

Treating ODD

The treatment for ODD is crucial to prevent more serious mental health conditions. Surely, each child’s characteristics must be taken into consideration in order to plan the best intervention for him or her. The child’s age, the severity of the symptoms and the possible causes of the disorder also play an important role in determining a plan of action.

Oppositional Defiant Disorder in children

Treating ODD

Consequently, parent training programs, cognitive behavioral therapy, family therapy, social skills programs and sometimes medication, are the most common treatments. In general, the goals are:

  • Anger management (read more about child anger)
  • Coping with stressful events in a positive way
  • Enhance problem-solving skills
  • Improving relationships with peers
  • Teaching discipline techniques to parents, family and teachers

Even though the treatment can last several months or longer, improvement can be achieved in most cases. Studies show that in  67% of the cases, the symptoms disappear after three years. The other ˜30% could develop a Conduct Disorder (CD).

Medication

It’s important to note that medication alone hasn’t been proven to be effective. However, it can be prescribed for treating and controlling specific behavior, especially when ODD is combined with other conditions like ADHD, anxiety and/or mood disorders. In these cases, effectiveness has been successful (need help choosing the best ADHD medication for your child?).

Parent-Management Training

Parent training programs have been proven to be effective. Sometimes the parent-child relationship is so damaged from past negative experiences that it’s difficult to change the techniques without professional help. For this reason, these programs are focused on positive ways of managing behavior, discipline techniques, and accurate strategies according to the child’s age.

Many of the techniques that are taught in these parent training programs focus on positive reinforcement. The parent is encouraged to acknowledge and celebrate when their child is flexible and cooperative. The program also tries to help parents shy away from punishment and using negative reinforcement, as it has been proven to be less effective.

Also, being a model for the kid is important. Taking a time-out if you’re noticing the situation is going the wrong way will surely prevent the conflict from ending up worse. Respect when your child asks for a time-out. Give them their space and don’t press the issue any further until they’ve calmed down. Being conscious and aware of when the child might lose control is an important step towards progress and should be recognized.

Finally, reading books or professional articles about ODD is a good way to understand better your child’s condition. As a result, this will help improve the relationship parent-child and avoid labeling.

Oppositional Defiant Disorder in children

Improving the relationship parent-child with ODD

Marcela is a psychologist specialized in Neuropsychological Rehabilitation by the Universidad Autónoma de Barcelona and is currently specializing on Rational Emotive Behavior Therapy. She’s passionate about volunteering and sharing experiences with people with brain injury as well as trying to help the disabled improve their quality of life. She believes that random acts of kindness make a difference in the world.