What is Oppositional Defiant Disorder (ODD)?
Oppositional defiant disorder (ODD) is a childhood behavioural problem characterised by an angry or irritable mood and constant disobedience and hostility. Around one in 10 children under the age of 12 years are thought to have ODD, with ODD occurring more frequently in boys.
Early intervention and treatment is important, as untreated ODD may continue, impacting on a child's relationships with family, peers, teachers. When ODD persists, it can result in significant impairment with relationships, career prospects and quality of life. Some children with ODD will develop the more serious conduct disorder (CD), which is characterised by aggressive law-breaking and violent behaviours.
Oppositional Defiant Disorder (ODD) is characterized by the frequent occurrence of at least four of the following behaviours:
- Frequent temper tantrums
- Is touchy or easily annoyed
- Is often angry and resentful
- Often argues with adults or authority figures, often the most familiar adults in their lives such as parents
- Often actively defies or refuses to comply with requests
- Often deliberately annoys others
- Often blames others for his or her own mistakes or misbehaviour
- Spiteful or vindictive behaviour.
What age does ODD begin?
ODD behaviours usually appear during the pre-school or primary years, and rarely emerge later than early adolescence.
A child with ODD will display a pattern of angry or irritable mood, or argumentative and defiant behaviour, or vindictiveness. While most parents can probably identify those traits in their children from time to time, children with ODD persist in these behaviours for at least six months.
Negativistic and defiant behaviours are expressed by persistent stubbornness, resistance to directions, and unwillingness to compromise, give in, or negotiate with adults or peers. Defiance may also include deliberate or persistent testing of limits, usually by ignoring orders, arguing, and failing to accept blame for misdeeds.
ODD behaviours are almost invariably present in the home setting, but may not be evident at school or in the community. Usually individuals with this disorder do not regard themselves as oppositional or defiant, but justify their behavior as a response to unreasonable demands or circumstances.
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Parents are often intimidated by their child’s behaviour because it’s so difficult to deal with; sometimes it just seems easier to give in than to deal with trying to manage and respond differently.
Treatment for ODD
The quality of parenting seems to be an important factor and the central focus of therapy with oppositional defiant disorder (ODD)is usually behavioural, implemented through parent training. This is designed to help the parents better manage and interact with their child, including behavioural techniques that reinforce good behaviour and discourage bad behaviour. This is the primary form of treatment and the most effective.
The parent training can often be done in a group setting (to help reduce costs and increase social support), or privately. Parents learn specific behavioral techniques which help increase the likelihood of maintaining control in the relationship with the child. Gradual shaping of the child's behaviour toward more age-appropriate behaviors is accomplished through the implementation of a behavioural monitoring and reward program. Mindworx Psychology offers parent training courses such as 1-2-3 Magic and Emotion Coaching and Engaging Your Adolescent.
Functional family therapy may also be helpful to teach all family members to communicate and problem-solve more effectively. Parents may find a parent training class to be more effective as well as less expensive; it therefore is typically tried first before family therapy.
Finally, consistency of care is important – meaning all carers of the child (including parents, grandparents, teachers, child care workers and so on) need to be consistent in the way they behave towards and manage the child.
Tips to help manage your child's oppositional behaviour
Respond without anger: Try to be as calm and matter-of-fact as possible. Acknowledge the behaviour, state it as you see it, explain how it will need to change and then remove yourself from all arguments. You have to pick your battles and decide what’s most important to you—and ultimately to your child, and this an area parent training can help with.
- Be clear and consistent: When a child displays a great deal of oppositional behaviour parents often report they feel worn out and give in. You need to be strong, clear and consistent in your follow through, and parent training can help you develop a clear and consistent approach.
- Try not to take things personally. As hard as it might be, it will help if you can remain as neutral and objective as possible. You need to be clear and concise and not get pulled into a power struggle. It can be incredibly helpful for parents to learn skills to manage their own emotions effectively, as parenting effectively is about your child and what he or she needs to learn. It's not always easy! The key is to keep practicing calm parenting and following through consistently.
- Some parent's find the saying "Don’t be your child’s friend—be his parent" helpful. There are times when your child won’t like your discipline. They may even shout, “I hate you,” or call you names. But if you keep setting reasonable and consistent limits with your child and follow through by giving them consequences and holding them accountable, then ultimately you’re doing the best thing for your child.
- Get help! Visit your G.P. or Paediatrician - ODD can persist without help and significantly affect your child's relationships and emotional well-being. Early intervention is important: ODD may co-occur with ADHD, and children with ODD may be at increased risk for anxiety and mood disorders. Do see a specialist who can check there are no other factors contributing to their behaviour. Ask about parent training or support groups in your area.
- Take care of yourself. Most parents would agree that parenting can be very challenging at times. Parenting a child with oppositional or defiant behaviour can feel incredibly stressful. Looking after your own physical and emotional wellbeing is important.